Herbal self-medication use in Type 2 diabetes mellitus.

* Correspondence: elifonder61@yahoo.com To the Editor, We read the article entitled “Herbal self-medication use in patients with diabetes mellitus type 2” by Damnjanovic et al. in a recent issue of the Turkish Journal of Medical Science with great interest (1). We thank Dr Damnjanovic and colleagues for their interesting and also important investigation on herbal self-medication use in type 2 diabetics. They reported that type 2 diabetics have used different types of herbal product in daily life. Especially they found 5 important herbal products usage: ginseng, garlic, aloe, cinnamon, and St. John’s wort. We published a similar article about herbal therapy in type 2 diabetics in a Turkish diabetic population 2 years ago (2). Therefore, we wanted to make some comments on the article and this subject. Prevalence of herbal treatment use is very high in Turkish diabetic patients. Approximately 1/3 of diabetic patients have used different types of herbal products. Damnjanovic et al. reported 5 different types of herbal products. We detected approximately 20 different types of herbal products in our diabetic patients. They have most commonly used cinnamon, pepino, Prunus laurocerasus leaf, chamomile tea, cabbage juice, pomegranate flower, mulberry leaves, garlic etc. (2). We did not detect any favorable effect on control of diabetes because HbA1c levels were similar in both the herbal treatment and nonherbal group. We also investigated the factors influencing the use of herbal treatment. Patients were dissatisfied with the current medical treatment due to ineffectiveness, side effects, and hypoglycemia. Therefore, they tended to use herbal treatment. Dr Damnjanovic also reported that recommendations for herbal treatment arose from different sources. They reported that influencing decisions about herbal dietary supplements were media, friends, pharmacists, and physicians. We also detected similar findings. Advisers recommending herbal treatment in addition to medical therapy were as follows: neighbors or friends 45%, media 30%, health care workers (physicians and pharmacists) 13%, and herbalists 9%. In Turkey, one third of type 2 diabetic patients have used many different forms and types of herbal treatments regularly. The most important factors influencing herbal treatment use were dissatisfaction with current diabetic medicine and its side effects. In addition, other important factors leading to patients’ using herbal treatment were former users (friends, neighbors, and other patients) and the media. In conclusion, although various herbal treatments could be used as adjunctive therapy in addition to the current medical treatment, due to lack of evidence-based data in this field, potential severe adverse effects can result in death, depending on improper use. Moreover, to prevent misuse of herbal treatments for diabetic patients, we also recommend more educational programs on television or in the press about diabetes treatment. Received: 13.07.2015 Accepted/Published Online: 01.12.2015 Final Version: 23.06.2016 Letter to the Editor