Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus
Life-long insulin is the standard treatment for type 1 diabetes mellitus (T1DM). The role of traditional Chinese medicine (TCM) in T1DM is still not clear. The aim of this study is to explore the prescription pattern of TCM and its impact on the risk of diabetic ketoacidosis (DKA) in patients with T...
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| Veröffentlicht in: | Journal of ethnopharmacology 2016-09, Vol.191, p.324-330 |
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| creator | Lien, Angela Shin-Yu Jiang, Yi-Der Mou, Chih-Hsin Sun, Mao-Feng Gau, Bih-Shya Yen, Hung-Rong |
| description | Life-long insulin is the standard treatment for type 1 diabetes mellitus (T1DM). The role of traditional Chinese medicine (TCM) in T1DM is still not clear. The aim of this study is to explore the prescription pattern of TCM and its impact on the risk of diabetic ketoacidosis (DKA) in patients with T1DM.
We retrieved samples from the registry for catastrophic illness patients from the National Health Insurance Research Database (NHIRD). Based on a frequency (1:4) matched case-control design, patients with T1DM in 2000–2011 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with T1DM was analyzed. The incidence of DKA and the annual costs of emergency visits and hospitalizations were evaluated for all causes.
Overall, 416 subjects were TCM users, whereas a total of 1608 matched subjects were classified as non-TCM users. The most common Chinese herbal formula and single herb is Liu-wei-di-huang-wan (Six-ingredient pill of Rehmannia) and Huang-qi (Radix Astragali; Astragalus membranaceus (Fisch.) Bunge, Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao), respectively. Compared with non-TCM users, we found a 33% reduction in DKA incidence for all TCM users (aHR 0.67, 95% CI 0.56–0.81, p |
| doi_str_mv | 10.1016/j.jep.2016.06.051 |
| format | Article |
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We retrieved samples from the registry for catastrophic illness patients from the National Health Insurance Research Database (NHIRD). Based on a frequency (1:4) matched case-control design, patients with T1DM in 2000–2011 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with T1DM was analyzed. The incidence of DKA and the annual costs of emergency visits and hospitalizations were evaluated for all causes.
Overall, 416 subjects were TCM users, whereas a total of 1608 matched subjects were classified as non-TCM users. The most common Chinese herbal formula and single herb is Liu-wei-di-huang-wan (Six-ingredient pill of Rehmannia) and Huang-qi (Radix Astragali; Astragalus membranaceus (Fisch.) Bunge, Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao), respectively. Compared with non-TCM users, we found a 33% reduction in DKA incidence for all TCM users (aHR 0.67, 95% CI 0.56–0.81, p <0.000) and a 40% reduction for users receiving TCM treatment for more than 180 days (aHR 0.58, 95% CI 0.41–0.82, p <0.01). There were no significant differences between TCM users and non-users in the frequency and medical costs of emergency visits and hospitalizations.
Integrative TCM use may reduce the risk of DKA in patients with T1DM. Our results suggest that TCM may have a substantial positive impact on the management of TIDM.
[Display omitted]</description><identifier>ISSN: 0378-8741</identifier><identifier>EISSN: 1872-7573</identifier><identifier>DOI: 10.1016/j.jep.2016.06.051</identifier><identifier>PMID: 27340102</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Astragalus membranaceus (Fisch.) Bunge ; Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao: diabetic ketoacidosis ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Case-Control Studies ; Delivery of Health Care, Integrated - economics ; Delivery of Health Care, Integrated - trends ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 1 - economics ; Diabetes Mellitus, Type 1 - epidemiology ; Diabetic Ketoacidosis - blood ; Diabetic Ketoacidosis - economics ; Diabetic Ketoacidosis - epidemiology ; Diabetic Ketoacidosis - prevention & control ; Drug Costs ; Drug Prescriptions ; Drugs, Chinese Herbal - adverse effects ; Drugs, Chinese Herbal - economics ; Drugs, Chinese Herbal - therapeutic use ; Emergency Service, Hospital - economics ; Female ; Hospital Costs ; Hospitalization - economics ; Humans ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - economics ; Hypoglycemic Agents - therapeutic use ; Incidence ; Male ; Medicine, Chinese Traditional - economics ; Medicine, Chinese Traditional - trends ; National Health Insurance Research Database ; Practice Patterns, Physicians' - economics ; Practice Patterns, Physicians' - trends ; Registries ; Taiwan - epidemiology ; Time Factors ; Traditional Chinese medicine ; Treatment Outcome ; Type 1 diabetes mellitus ; Young Adult</subject><ispartof>Journal of ethnopharmacology, 2016-09, Vol.191, p.324-330</ispartof><rights>2016 Elsevier Ireland Ltd</rights><rights>Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-7e33679128cbb6216b62ab2feab7375704b2ffb04199813561d9cb3cff8e4c733</citedby><cites>FETCH-LOGICAL-c353t-7e33679128cbb6216b62ab2feab7375704b2ffb04199813561d9cb3cff8e4c733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0378874116304111$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27340102$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lien, Angela Shin-Yu</creatorcontrib><creatorcontrib>Jiang, Yi-Der</creatorcontrib><creatorcontrib>Mou, Chih-Hsin</creatorcontrib><creatorcontrib>Sun, Mao-Feng</creatorcontrib><creatorcontrib>Gau, Bih-Shya</creatorcontrib><creatorcontrib>Yen, Hung-Rong</creatorcontrib><title>Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus</title><title>Journal of ethnopharmacology</title><addtitle>J Ethnopharmacol</addtitle><description>Life-long insulin is the standard treatment for type 1 diabetes mellitus (T1DM). The role of traditional Chinese medicine (TCM) in T1DM is still not clear. The aim of this study is to explore the prescription pattern of TCM and its impact on the risk of diabetic ketoacidosis (DKA) in patients with T1DM.
We retrieved samples from the registry for catastrophic illness patients from the National Health Insurance Research Database (NHIRD). Based on a frequency (1:4) matched case-control design, patients with T1DM in 2000–2011 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with T1DM was analyzed. The incidence of DKA and the annual costs of emergency visits and hospitalizations were evaluated for all causes.
Overall, 416 subjects were TCM users, whereas a total of 1608 matched subjects were classified as non-TCM users. The most common Chinese herbal formula and single herb is Liu-wei-di-huang-wan (Six-ingredient pill of Rehmannia) and Huang-qi (Radix Astragali; Astragalus membranaceus (Fisch.) Bunge, Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao), respectively. Compared with non-TCM users, we found a 33% reduction in DKA incidence for all TCM users (aHR 0.67, 95% CI 0.56–0.81, p <0.000) and a 40% reduction for users receiving TCM treatment for more than 180 days (aHR 0.58, 95% CI 0.41–0.82, p <0.01). There were no significant differences between TCM users and non-users in the frequency and medical costs of emergency visits and hospitalizations.
Integrative TCM use may reduce the risk of DKA in patients with T1DM. Our results suggest that TCM may have a substantial positive impact on the management of TIDM.
[Display omitted]</description><subject>Adolescent</subject><subject>Adult</subject><subject>Astragalus membranaceus (Fisch.) Bunge</subject><subject>Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao: diabetic ketoacidosis</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Case-Control Studies</subject><subject>Delivery of Health Care, Integrated - economics</subject><subject>Delivery of Health Care, Integrated - trends</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - economics</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetic Ketoacidosis - blood</subject><subject>Diabetic Ketoacidosis - economics</subject><subject>Diabetic Ketoacidosis - epidemiology</subject><subject>Diabetic Ketoacidosis - prevention & control</subject><subject>Drug Costs</subject><subject>Drug Prescriptions</subject><subject>Drugs, Chinese Herbal - adverse effects</subject><subject>Drugs, Chinese Herbal - economics</subject><subject>Drugs, Chinese Herbal - therapeutic use</subject><subject>Emergency Service, Hospital - economics</subject><subject>Female</subject><subject>Hospital Costs</subject><subject>Hospitalization - economics</subject><subject>Humans</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - economics</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicine, Chinese Traditional - economics</subject><subject>Medicine, Chinese Traditional - trends</subject><subject>National Health Insurance Research Database</subject><subject>Practice Patterns, Physicians' - economics</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Registries</subject><subject>Taiwan - epidemiology</subject><subject>Time Factors</subject><subject>Traditional Chinese medicine</subject><subject>Treatment Outcome</subject><subject>Type 1 diabetes mellitus</subject><subject>Young Adult</subject><issn>0378-8741</issn><issn>1872-7573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v2zAMhoVixZp1-wG9FDru4ky0bMvGTkPQdgUK9NKdBVmmG6aJ7Ulyh9z7w8sg2Y4DCH4AL1-QjxBXoJagoPq2WW5wWubcLhVHCWdiAbXJM1Ma_UEslDZ1VpsCLsSnGDdKKQOF-igucqMLBSpfiLf7IeFzcIleUabgOko0Dm4rV2saMKLcYUeeW5nWGNy0lwG72WM8zDJQfJFjLztyLSby8gXT6Dx1Y6QoaZATG-OQovxDaS3TfkIJJzVb7HC7pTTHz-K8d9uIX071Uvy6vXla_cweHu_uVz8eMq9LnTKDWlemgbz2bVvlUHFybd6ja43ml1XBQ9-qApqmBl1W0DW-1b7vayy80fpSfD36TmH8PWNMdkfR8xFuwHGOFupcN6pRumIpHKU-jDEG7O0UaOfC3oKyB_h2Yxm-PcC3iqME3rk-2c8tY_u38Zc2C74fBchPvhIGGz3j8Yw4oE-2G-k_9u-0Upcr</recordid><startdate>20160915</startdate><enddate>20160915</enddate><creator>Lien, Angela Shin-Yu</creator><creator>Jiang, Yi-Der</creator><creator>Mou, Chih-Hsin</creator><creator>Sun, Mao-Feng</creator><creator>Gau, Bih-Shya</creator><creator>Yen, Hung-Rong</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160915</creationdate><title>Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus</title><author>Lien, Angela Shin-Yu ; Jiang, Yi-Der ; Mou, Chih-Hsin ; Sun, Mao-Feng ; Gau, Bih-Shya ; Yen, Hung-Rong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-7e33679128cbb6216b62ab2feab7375704b2ffb04199813561d9cb3cff8e4c733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Astragalus membranaceus (Fisch.) Bunge</topic><topic>Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao: diabetic ketoacidosis</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Case-Control Studies</topic><topic>Delivery of Health Care, Integrated - economics</topic><topic>Delivery of Health Care, Integrated - trends</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - economics</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetic Ketoacidosis - blood</topic><topic>Diabetic Ketoacidosis - economics</topic><topic>Diabetic Ketoacidosis - epidemiology</topic><topic>Diabetic Ketoacidosis - prevention & control</topic><topic>Drug Costs</topic><topic>Drug Prescriptions</topic><topic>Drugs, Chinese Herbal - adverse effects</topic><topic>Drugs, Chinese Herbal - economics</topic><topic>Drugs, Chinese Herbal - therapeutic use</topic><topic>Emergency Service, Hospital - economics</topic><topic>Female</topic><topic>Hospital Costs</topic><topic>Hospitalization - economics</topic><topic>Humans</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - economics</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicine, Chinese Traditional - economics</topic><topic>Medicine, Chinese Traditional - trends</topic><topic>National Health Insurance Research Database</topic><topic>Practice Patterns, Physicians' - economics</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Registries</topic><topic>Taiwan - epidemiology</topic><topic>Time Factors</topic><topic>Traditional Chinese medicine</topic><topic>Treatment Outcome</topic><topic>Type 1 diabetes mellitus</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lien, Angela Shin-Yu</creatorcontrib><creatorcontrib>Jiang, Yi-Der</creatorcontrib><creatorcontrib>Mou, Chih-Hsin</creatorcontrib><creatorcontrib>Sun, Mao-Feng</creatorcontrib><creatorcontrib>Gau, Bih-Shya</creatorcontrib><creatorcontrib>Yen, Hung-Rong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of ethnopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lien, Angela Shin-Yu</au><au>Jiang, Yi-Der</au><au>Mou, Chih-Hsin</au><au>Sun, Mao-Feng</au><au>Gau, Bih-Shya</au><au>Yen, Hung-Rong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus</atitle><jtitle>Journal of ethnopharmacology</jtitle><addtitle>J Ethnopharmacol</addtitle><date>2016-09-15</date><risdate>2016</risdate><volume>191</volume><spage>324</spage><epage>330</epage><pages>324-330</pages><issn>0378-8741</issn><eissn>1872-7573</eissn><abstract>Life-long insulin is the standard treatment for type 1 diabetes mellitus (T1DM). The role of traditional Chinese medicine (TCM) in T1DM is still not clear. The aim of this study is to explore the prescription pattern of TCM and its impact on the risk of diabetic ketoacidosis (DKA) in patients with T1DM.
We retrieved samples from the registry for catastrophic illness patients from the National Health Insurance Research Database (NHIRD). Based on a frequency (1:4) matched case-control design, patients with T1DM in 2000–2011 were designated as cases (TCM users) and controls (non-TCM users). TCM treatment for patients with T1DM was analyzed. The incidence of DKA and the annual costs of emergency visits and hospitalizations were evaluated for all causes.
Overall, 416 subjects were TCM users, whereas a total of 1608 matched subjects were classified as non-TCM users. The most common Chinese herbal formula and single herb is Liu-wei-di-huang-wan (Six-ingredient pill of Rehmannia) and Huang-qi (Radix Astragali; Astragalus membranaceus (Fisch.) Bunge, Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao), respectively. Compared with non-TCM users, we found a 33% reduction in DKA incidence for all TCM users (aHR 0.67, 95% CI 0.56–0.81, p <0.000) and a 40% reduction for users receiving TCM treatment for more than 180 days (aHR 0.58, 95% CI 0.41–0.82, p <0.01). There were no significant differences between TCM users and non-users in the frequency and medical costs of emergency visits and hospitalizations.
Integrative TCM use may reduce the risk of DKA in patients with T1DM. Our results suggest that TCM may have a substantial positive impact on the management of TIDM.
[Display omitted]</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>27340102</pmid><doi>10.1016/j.jep.2016.06.051</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Astragalus membranaceus (Fisch.) Bunge Astragalus membranaceus var. mongholicus (Bunge) P.K.Hsiao: diabetic ketoacidosis Blood Glucose - drug effects Blood Glucose - metabolism Case-Control Studies Delivery of Health Care, Integrated - economics Delivery of Health Care, Integrated - trends Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - economics Diabetes Mellitus, Type 1 - epidemiology Diabetic Ketoacidosis - blood Diabetic Ketoacidosis - economics Diabetic Ketoacidosis - epidemiology Diabetic Ketoacidosis - prevention & control Drug Costs Drug Prescriptions Drugs, Chinese Herbal - adverse effects Drugs, Chinese Herbal - economics Drugs, Chinese Herbal - therapeutic use Emergency Service, Hospital - economics Female Hospital Costs Hospitalization - economics Humans Hypoglycemic Agents - adverse effects Hypoglycemic Agents - economics Hypoglycemic Agents - therapeutic use Incidence Male Medicine, Chinese Traditional - economics Medicine, Chinese Traditional - trends National Health Insurance Research Database Practice Patterns, Physicians' - economics Practice Patterns, Physicians' - trends Registries Taiwan - epidemiology Time Factors Traditional Chinese medicine Treatment Outcome Type 1 diabetes mellitus Young Adult |
| title | Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus |
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