Use of Complementary and Alternative Medicine (CAM) for Type 2 Diabetes Management in a Florida Farm Working Community

Background: In 2014, approximately 29.1 million people in the US were estimated to have type 2 diabetes.  Latino farmworkers carry a disproportionate burden of type 2 diabetes and face numerous challenges to accessing health care and self-management.  Cultural beliefs of Latino diabetics have been found to have an impact on their treatment behaviors. The majority of Latinos use some type of complementary and alternative medicine (CAM) to control their glucose levels. This presentation focuses on the understanding of the CAM practices among diabetic Latinos living in a farmworking community.

Methods: Latinos diagnosed with type 2 diabetes were recruited from a faith-based community clinic in Central West Florida. Ethnographic interviews (n=30) were conducted in Spanish using socio-demographic, freelist and open-ended questions.  Applied thematic analysis techniques were employed to analyze qualitative data using Atlas.ti7. 

Results: More than half of the participants indicated current or previous use of CAM (specifically home remedies) as a form of diabetes management. Various home remedies utilized by participants included: bitter herbal teas, fruit shakes, sabila (aloe vera), and nopal (prickly pear cactus).  Participants reported having learned about home remedies mainly from family members and acquaintances, many of whom were diabetics.  Reasons for using home remedies included: inability to afford medications and/or access medical care, to maintain glucose levels, relieve common symptoms, improve quality of life, complement prescribed medications, and to a lesser extent cure diabetes. Participants who did not use home remedies discussed their uncertainty of the safety and usefulness of the ingredients, personal preference for biomedical treatment and compliance with health care provider recommendations. Mixed perceptions and assumptions of providers’ views and reactions influenced whether participants disclosed the use of home remedies.

Conclusion: Family and cultural beliefs, as well as financial means are factors that determine the use of home remedies to self-manage type 2 diabetes among Latinos in this farmworking community. There is a clear need and desire for providers to acknowledge the cultural practices and preferences of this subgroup of Latino diabetics and to discuss the potential positive and negative interactions between home remedies and biomedical treatment for the management of type 2 diabetes. The findings of this study contribute to a better understanding the patterns of home remedy use and the decision-making processes regarding their use. Our findings can inform the design of culturally appropriate diabetes education and self-management plans. Further research is needed to investigate the efficacy of these home remedies and the use of other types of CAM treatments among diabetic Latinos in farmworking communities.