Complementary and Alternative Medicine Use in Diabetic Foot Ulcer Patients at a Shiraz Diabetes Clinic: A Cross-Sectional Study

Background: Diabetic foot ulcers (DFU) are common and serious, often leading to high mortality and recurrence rates. Despite conventional treatments, many patients turn to traditional medicine. Objectives: This study examines the use of complementary and alternative medicine (CAM) in the treatment of these ulcers. Methods: This descriptive-analytical cross-sectional study was conducted on 300 DFU patients in Shiraz who visited the wound clinic in late 2021. Data were collected using a standard questionnaire, database management system (DBMS), and a file system. The questionnaire included information on traditional complementary/alternative measures, resources providing CAM, and the use of herbal medicines and nutritional supplements. Linear, ordinal, and logistic regression models were used for data analysis. Results: Among the participants (mean age 58.35; 62% male), 54% had moderate ulcers, and 83% had neuropathy. While only 46 (15.3%) participants followed lifestyle management principles, 254 (84.7%) used CAM, and 238 (79.3%) reported a history of using medicinal plants, with chamomile being the most frequently used (48.7%). Females were significantly less likely to use CAM compared to males (OR = 0.35; CI: 0.16 - 0.75). Similarly, residing in an urban area was associated with a significantly lower likelihood of CAM use compared to rural areas (OR = 0.13; CI: 0.06 - 0.31). A history of using phlebotomy (β = -1.42, P = 0.001), massage (β = -2.39, P = 0.003), acupuncture (β = -2.41, P = 0.002), spiritual treatments (β = -2.32, P = 0.026), green tea (β = -0.51, P = 0.026), and Urtica (β = -0.64, P = 0.025) were significantly associated with a lower grade on Wagner's classification. Additionally, the use of Sumac (OR = 0.39; CI: 0.23 - 0.68) and Eryngo tincture (OR = 0.51; CI: 0.28 - 0.93) were significantly associated with A1C < 7. Conclusions: Complementary and alternative medicine use is widespread among diabetic patients in Iran. Education on CAM and professional guidance are essential, along with further research to understand the impact of CAM on diabetes management.