Comparative Glycemic Control in Adult Patients with Type 2 Diabetes on Herbal and Conventional Glucose-Lowering Agents in Nairobi County, Kenya

Background: Some diabetic patients seek care exclusively from traditional herbal practitioners. It is not known if the care provided by herbalists is effective in maintaining optimal glycemic control.

Aim: To compare glycemic control in adult patients with type 2 diabetes on treatment with conventional medicines against those on herbal glucose-lowering therapies.

Study Design: Descriptive cross-sectional study.

Place and Duration of Study: Patients on conventional treatment were recruited from the Endocrinology and Diabetes Outpatient Centre at Kenyatta National Hospital. The comparative group was enrolled from the New Life Herbal Clinic. The study was carried out between March 2019 and December 2021.

Methodology: We recruited 80 patients on treatment with conventional antidiabetic therapies at Kenyatta National Hospital (KNH) and 37 patients on herbal therapies at New Life Herbal Clinic (NLHC). A structured questionnaire was used to collect sociodemographic and clinical data. Consecutive sampling was used to recruit the study participants. Glycated hemoglobin (HbA1C) levels were measured at the time of the patient visit.

Patients with HbA1c levels <7% were considered to have achieved adequate glycemic control. Descriptive and inferential data analysis was performed on all the variables and compared across the two study arms. Regression analysis was performed to identify variables associated with glycemic control for each treatment group. Data were entered into and analyzed using SPSS software version 26 (SPSS Inc, Chicago, USA). P-values <0.05 were considered to be statistically significant.

Results: Patients on conventional antidiabetic medications had significantly lower mean HbA1c levels (7.40+1.92) % compared to (8.34+1.97) % in the herbal treatment arm (P=0.016). Significant differences in mean HbA1c % were reported in patients on a combination of 5-6 herbs (7.06 +1.54) % compared to those on 3-4 herbs (8.63+1.91) % (P= 0.045). Significant predictors of adequate glycemic control (HbA1c< 7%) were having a past HbA1c check ( (aOR= 3.098 (95% C.I=1.258-7.631) P=.014), adherence to medications ( (aOR= 6.055 (95% C.I=1.623-22.593) P= .007), treatment with Launaea cornuta ( (aOR= 7.143 (95% C.I=1.462-34.893) P= 0.015) and being married (aOR=2.870 (95% C.I=1.054-7.818) P=0.039).

Conclusion: Patients on treatment with conventional agents reported better glycemic control compared to those on herbal therapies. Regular monitoring of HbA1c, adherence to medications, having a spouse and treatment with Launaea cornuta may enhance blood glucose control in patients with type 2 diabetes.