Very few of our subjects reported using herbs with any regularity (Table 2). Nearly two thirds who named herbs said they had never tried them or had only tried them once or twice, while less than a third said they had regularly used them in the past. Only 9% said they currently use herbs regularly.
Not surprisingly, several of those reporting using herbs regularly felt the herbs helped control their blood sugar. One patient explained his belief that herbs can help in these terms: “What sustains our bodies is what we extract from the earth. So, I mean, what’s wrong with medicinal herbs if they’re doing good?”
The majority of patients, however, were more skeptical about the value of using herbs:
“I’ve heard of them, but I don’t really care too much about them. There’re a lot of people that say herbs can help with the diabetes, but I don’t like to try them. I might be allergic to them or something, or I might get worse off than I am. I’m not gonna take a chance and take something like that.”
“I’ve heard of some [herbs], but I never used any of them. My mother tried them, but I don’t know. I just don’t believe in all that. It’s like remedies for older people.”
“People tell me about [teas], but I haven’t tried any yet. I just take my medicine. If they can’t cure you with medicine, you know, the earth ain’t gonna help you. I don’t want to mix up anything with my medicine.”
Even when people have tried herbs for their diabetes, it cannot be assumed that they believe in their efficacy. Nearly half of those who had tried herbs said they did not help with diabetes or may even have been harmful. In contrast, less than a third felt herbs had a noteworthy positive effect on their illness (Table 2).
Prayer and Curanderos
When asked if they thought God or prayer helped their diabetes, 77% (17/22) said yes (Table 2). It is important to consider the specific ways they believed prayer helps. Most did not think prayer could have a direct impact on their diabetes but instead thought it helped indirectly by reducing their stress and anxiety. A typical comment was: “I ask God to help me with my diabetes. I pray for Him to give me the strength to go on. It makes me feel more tranquil, calmer.”
Several patients (27%, 6/22) said God had a direct influence on their disease management, but this did not excuse them from vigorously pursuing medically recommended treatments. Contrary to the common assumption in the medical literature, we found no patient who thought prayer or God’s help could replace medical treatment. Instead, these patients saw medical treatment as the vehicle through which God would heal them. As one patient explained:
“You have to ask God’s help, you have to pray. God gives the means. He gives us doctors and the medicine, so that they can help us. But, we can’t leave everything to Him. We have to take hold of the means. See, it’s the medicine, but first of all it’s God, and then the medicines. Have faith in what the doctor prescribes.”
Similarly, we found no evidence that these patients turned to traditional healers, such as curanderos, for their diabetes. We did not find a single case of a patient having consulted a curandero for diabetes management. The use of curanderos for any condition among those we interviewed was very rare: Only 3 had ever used a curandero, and all had done so only once and only for diseases other than diabetes (Table 2). Our participants were unanimously skeptical about curanderos:
“I’d rather take the medicine from the doctor than go to the curandero. I don’t believe in them. I think the doctor is best.”
“You have to believe in them (curanderos) for it to work, and I really don’t have trust in them.”
“I wouldn’t have any faith in those guys to tell you the truth. I just don’t think they work. ‘Curandero!’” (Laughs)
Interaction Between Alternative and Biomedical Treatments
We have seen no evidence of any conflict or competition between alternative and conventional treatments among these patients. On the contrary, their comments indicate they may give priority to biomedical regimens over alternative ones. To test this observation, we compared each patient’s level of involvement with biomedical and alternative treatments. On the basis of the individual’s self-reports of treatment behaviors, we classified their level of activity in each type of treatment as high, medium, or low. A scoring method was devised that produced composite scores, reflecting level of activity in each of 3 dimensions of each treatment type. Two researchers independently classified all cases; any discrepancies in classification between them were resolved in meetings of the entire research team.