Research Study on Serinity Prayer healing diseases

Use of the Serenity Prayer Among Adults
With Type 2 Diabetes
A Pilot Study
■ Lisa M. Sacco, DNP, RN, APRN-BC ■ Mary T. Quinn Griffin, PhD, RN
■ Sister Rita McNulty, DNP, RN, CNP ■ Joyce J. Fitzpatrick, PhD, RN, FAAN
The incidence of type 2 diabetes is rising rapidly with significant associated morbidity and mortality. Treatment
efforts are focused on control of serum blood glucose levels. It was anticipated that the use of the Serenity Prayer
would assist those who need to gain control over their physiological symptoms. A pilot study of the effect of daily
recitation of the Serenity Prayer for 6 weeks on serum blood glucoses in patients with uncontrolled type 2 diabetes
was implemented. Thirty-six participants were enrolled in the study; there was a very high attrition rate over the
course of the study. Serum blood glucose levels over the duration of the study were analyzed. At 4 to 6 weeks, time
2, there were 2 participants who had lower serum blood glucose levels, 2 had increased serum blood glucose
levels, and 4 had no change. Challenges in completing this research and specific recommendations for future
research are addressed. KEY WORDS: prayer, research challenges, selfcare management, serenityprayer, type 2
diabetes Holist Nurs Pract 2011;25(4):192–198
Prayer is widely practiced in the United States and
has become inextricably intertwined with the healing
process of those under medical care.1 In an
increasingly diverse and pluralistic society, prayer
remains a constant. In a study of 8000 total
participants with 5000 of those having diabetes,
hypertension, dyslipidemia, and/or heart disease,
almost one-half of the participants prayed in relation
to health and 90% of those believed that prayer was an
effective way to improve health.2
Yet, despite the pervasiveness of prayer in social,
religious, and health care settings, few studies have
been conducted that specifically address prayer as an
intervention as related to physiological outcomes. This
may be due in part to the difficulties associated with
controlling for prayer as an intervention. For nurses to
practice holistically, it is important to understand
prayer, including how the practice of prayer may
affect health outcomes.
Author Affiliations: Emergency Department, Naval Medical Center San
Diego, California (Dr Sacco); and Frances Payne Bolton School of Nursing,
Case Western Reserve University, Cleveland, Ohio (Drs Quinn Griffin and
Fitzpatrick and Dr McNulty).
Correspondence: Joyce J. Fitzpatrick, PhD, RN, FAAN, Frances Payne
Bolton School of Nursing, Case Western Reserve University, 10900 Euclid
Ave, Cleveland, OH 44106 (Joyce.fitzpatrick@case.edu).
DOI: 10.1097/HNP.0b013e31822273a8
Diabetes and its associated morbidity and mortality
are on the rise in the United States. Most studies of
diabetes have been focused on clinical outcome
measures, glycemic control, disease complications, or
compliance with disease-specific regimens.3 Because
diabetes is a complex disease, there is a need to
address aspects of living with diabetes. Self-care is
one of the most important things a diabetic patient can
do to increase the quality and the quantity of their life.
Self-care for diabetic patients includes general,
therapeutic lifestyle interventions as well as home
serum blood glucose monitoring. Yet researchers have
shown that self-care in diabetic patients is far from
optimal.4
There is no research evidence for the effect of
prayer as a component of self-care management in
diabetes. A critical review of the literature
demonstrated a large body of research on prayer
practices, types of prayer for health, and reasons for
prayer.5-8 The present pilot study was focused on the
use of the Serenity Prayer as a self-care intervention
among patients with diabetes. This specific prayer was
chosen as it incorporated an aspect of self-control in
the words of the prayer and seemed to the
investigators to be consistent with an emphasis on
self-care. No research to date has incorporated the
Serenity Prayer as an intervention. Yet this prayer
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
192
Use of the Serenity Prayer Among Adults With Type 2 Diabetes 193
appears to be particularly well suited to study in those
with chronic disease because of its inherent
self-management focus. The Serenity Prayer is as
follows: “God grant me the serenity to accept the
things I cannot change, the courage to change the
things I can, and the wisdom to know the difference.”
BACKGROUND
In the literature, 2 types of prayer are discussed:
intercessory prayer (IP) and individual or personal
prayer. Individual prayer has been practiced for
centuries and is defined as personal communication
with one’s God or the higher power of one’s belief
system.1 Both types of prayer have been found to have
significant positive effects on those praying as well as
on those being prayed for. Little is known about the
efficaciousness of specific prayers and the effects of
specific prayers such as the Serenity Prayer.
Intercessory prayer, and its effects on a group of
persons who were remote and unknown to those
communicating the prayers, is a common method of
studying prayer. A large number of research studies
have been dedicated to IP and the prayer outcomes
on those for whom prayers were said.9-11 In a
meta-analysis of IP, in 7 of the 17 studies reviewed,
IP had a clear benefit to the patient.5
Praying for health has been found to be a common
practice among adults. As opposed to a general
practice of personal prayer, prayer for health involves
the person specifically praying for their health. The
number of people praying for health is quite large,
43% in a recent Centers for Disease Control and
Prevention study.12 Also extremely common is the
belief in the efficacy of praying for health.1 In a study
of alternative therapy use among 4404 adults, prayer
emerged as the most common alternative therapy;
40% of the subjects reported that they prayed for
health and 90.3% of those believed that prayer was
related to improved health.2
Prayer as a form of complementary and
alternative medicine
A report from the 2002 National Health Interview
Survey conducted by the Centers for Disease Control
and Prevention’s National Center for Health Statistics
provides an overview of complementary and
alternative medicine (CAM) use among US adults
(N = 31 044).12 Prayer was exceedingly common,
both for one’s own health (43%) and for the health of
others (24.4%). Excluding prayer for the sake of
health, the percentage of US adults who had used
CAM in the past 12 months decreased from 62.1% to
36%. These researchers found a surprising 27.7% of
respondents who used CAM because they believed
that traditional western medicine would not help with
their particular health care problem.12
In the 2002 National Health Interview Survey
among persons with chronic disease (arthritis, cancer,
diabetes), prayer and megavitamins were the most
frequently used CAM.13 There were 2474 adults with
diabetes in the sample. Compared with the general
population, persons with diabetes were more likely to
use prayer and less likely to use herbs, yoga, or
vitamins.14 Also, researchers found that, among
diabetic patients who reported using CAM, solitary
prayer/spiritual practices were the most commonly
used CAM.15
Another group of researchers studied CAM use
among 68 rural African Americans with type 2
diabetes.6 Participants were asked about religion and
faith and the relationship to their diabetes. The
majority reported faith in God and prayer being
important in their lives. Three themes emerged: prayer
and faith in God as a coping mechanism for dealing
with diabetes, God guiding health care providers, and
a relationship between faith and conventional
treatment.6
Summary of existing knowledge and gaps in the
research
Complementary and alternative medicine researchers
demonstrated a high level of prayer in all populations
studied and a belief in the positive effect of prayer.
Particularly important to the present study is that no
studies were found in which personal prayer was
tested as a self-care intervention for persons with
diabetes. The pilot study was designed to fill this void.
METHODS
A quantitative quasi-experimental design was used to
determine whether the recitation of the Serenity
Prayer affected serum blood glucose levels in patients
with type 2 diabetes with a starting hemoglobin A1C of
more than 7.5%. This study took place at a federally
qualified health center in southern California. Data
were collected at 3 time points.
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
194 HOLISTIC NURSING PRACTICE • JULY/AUGUST 2011
Sample
The study sample included type 2 diabetic patients
with a hemoglobin A1C more than 7.5%; type 2
diabetes was defined as a disease in patients having 2
fasting blood glucose levels greater than 125 mg/dL
or a single random fasting glucose level greater than
200 mg/dL. These patients were identified from a
chronic disease registry; all of those identified were
invited to participate in the study. All tools were
translated into Spanish to allow for monolingual
Spanish speakers to participate. Exclusion criteria
included anyone with a significant immune modifying
illness at the start of enrollment such as cancer or
pneumonia. A 10% attrition rate was assumed and
79 patients were identified as possible participants.
Instruments
Serum blood glucose monitors and test strips were
provided to the patients. The monitor was Bayer
Breeze2, which does not need calibration or test strip
coding. Reliability and validity of the Breeze2
glucometer had previously been determined.16
Patients were instructed on the use of the monitors by
the primary investigator.
Background questions were asked about age,
marital status, and work status. A series of questions
regarding health, specifically heart disease and
diabetes, was also asked. In addition, participants were
asked questions regarding prayer, including how
frequently they prayed, what prayers they used, and
where they prayed.
Qualitative questions were included in the time 2
questionnaire. The 5 questions were as follows: When
you were asked to say the Serenity Prayer was there
anything about that particular prayer that you thought
of? The second question asked whether the Serenity
Prayer was added or substituted for the participants’
regular prayers. The third question asked whether
saying the Serenity Prayer changed anything about the
way the participants were living their lives and the
fourth question asked specifically whether saying the
Serenity Prayer changed anything about the way the
participants were living with their diabetes. There was
one open-ended question that allowed participants to
share any thoughts they had on being in the study.
The serum blood glucose diary was given at time 1
and had 3 boxes with 4 spaces in each box for 4 serum
blood glucoses per week, for 3 weeks. The
participants were asked to check their blood glucose
levels on 1 week day and 1 weekend day per week.
The diary had the days of the week to circle and a
space for the time the blood glucose level was
checked. The serum blood glucose diary was
explained to each patient at enrollment. The prayer
diary had the exact same 3 boxes at the top for weeks
4 to 6. Participants were asked to use this form to
record each time they recited the Serenity Prayer.
Procedures
Once institutional review board approval was granted,
a registry summary report of the patients assigned to
the nurse practitioner at the chosen clinic having a
hemoglobin A1C more than 7.5 was run. Patients were
contacted by the bilingual staff and an opportunity to
participate in the study was offered. During the
telephone call, the study was explained by the staff
using a script provided by the primary researcher. If
the patient expressed interest, an appointment was
made. At this appointment, any regularly scheduled or
requested patient care was rendered prior to the study
being discussed.
At time 1 the participants filled out the background
data, including prayer practices and background health
data. Serum blood glucose diaries for the first 3 weeks,
along with the glucometer, were given to participants
at that first visit and the patients were taught the
Serenity Prayer and instructed to recite the prayer at
least once daily. They were not given any other
instructions about when to say the prayer and under
what conditions. The participant was asked to
self-address a manila envelope that would be sent to
them at week 2 with their week 3 to 6 materials. The
prayer diary and a copy of the Serenity Prayer were
mailed to the participant’s home with the second
questionnaire. At the end of their 6 weeks, the
participant was asked to return the stamped
self-addressed envelope with all of his or her materials
inside. The participants were given a Bayer Breeze 2
glucometer to keep whether they completed the study
or not. The participants were also given 2 one-dollar
bills at enrollment (Time 1) and in their manila
envelopes at times 2 and 3.
RESULTS
Of the original 79 patients identified from the diabetic
registry, only 49 were able to be contacted. Only 1
patient refused to participate, citing lack of adequate
compensation. Either the remainder had discontinued
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Use of the Serenity Prayer Among Adults With Type 2 Diabetes 195
phone numbers or were no longer living at the phone
number on the registry report, or the phone rang with
no answer or no answering machine.
Of the 48 persons who were contacted and agreed
to come to the clinic for more information, 15 never
presented even after 2 follow-up phone calls. The
enrollment period lasted 6 weeks. The final enrollment
number was 36, thus only 45% of the 79 possible
participants were identified.
An attempt was made during the study period to
call patients on a weekly basis and remind them of the
need to follow the study guidelines. These phone calls
often resulted in messages being left. Of the original
36 enrollees, only 12 turned in any completed
materials at week 6.
Characteristics of the participants who
completed the time 1 data
Thirty-six participants completed the initial
questionnaires. The sample consisted of 23 women
(63.9%) and 13 men (36.1%) with a mean age of 50.31
years (SD = 12.35; range, 28-73). The majority of the
sample was African American (n = 15; 41.7%) or
Hispanic (n = 16; 44.4%) and single (n = 15; 41.7%).
Sample characteristics are included in Table 1.
Prayer practices
The time 1 questionnaire included specific questions
on prayer practices. The majority of participants
prayed regularly (n = 35; 69.4%), and equal numbers
prayed for themselves and their health (n = 30;
83.3%), while equal numbers also reported praying for
others and others’ health (n = 26; 72.2%). The
majority of the participants prayed quietly alone
(n = 35; 83.3%). The prayer characteristics of the time
1 participants are found in Table 2.
Serum blood glucose levels and Serenity Prayer
results
Twelve participants turned in their completed
serum blood glucose diaries for weeks 1 through 3;
mean serum blood glucose level was 185 (SD =
64.48). Ten participants completed their serum blood
glucose diaries for weeks 4 through 6; mean serum
blood glucose level for weeks 4 through 6 (n = 10)
was 225 (SD = 83).
A total of 9 people reported reciting the Serenity
Prayer. The mean number of times participants recited
the Serenity Prayer daily was 1.65 (SD = 1.13). From
weeks 1 to 6, 4 participants had a decrease in their
TABLE 1. Background Characteristics of the
Participants (N = 36)
Variable Frequency % Mean ± SD
Age, y 50.3 ± 12.3
28-44 10 27.8
45-61 18 50.0
62-73 8 22.2
Gender
Female 23 63.9
Male 13 36.1
Ethnicity
Hispanic 16 44.4
African American 15 41.7
White 2 5.6
Asian/Pacific Islander 1 2.8
Marital status
Single 15 41.7
Married 11 30.6
Widowed 1 2.8
Divorced 6 16.7
Separated 3 8.3
Insurance status
Uninsured 5 13.9
County Medical 15 41.7
Medi-Cal 6 16.7
Medi-Cal and Medicare 5 13.9
Medicare 5 13.9
Completed high school
Yes 18 50
No 18 50
Working, full- or part-time
Yes 7 19.4
No 28 80.6
serum blood glucose levels, and 5 participants showed
an increase in serum blood glucose levels. What is
interesting to note is the fluctuation in serum blood
glucose levels among 8 of the 9 participants from
weeks 1 through 6. These results are included in
Table 3.
Time 1 qualitative question
The time 1 questionnaire had one qualitative
question asking about specific prayers that participants
might be using. The question was answered by 23
participants with 5 reporting no specific prayers and 1
reporting yes but not detailing what prayer it was. The
Lord’s Prayer was chosen 5 times and the rosary
twice. Two participants reported reciting psalms, and
one person reported recitation of the Serenity Prayer.
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
196 HOLISTIC NURSING PRACTICE • JULY/AUGUST 2011
TABLE 2. Results on Questionnaire Concerning
Prayer Practices (N = 36)
Variable Yes, f (%) No, f (%)
Pray regularlya 25 (69.4) 10 (27.8)
Pray for yourselfa 30 (83.3) 5 (13.9)
Pray for your healtha 30 (83.3) 5 (13.9)
Pray for othersa 26 (72.2) 9 (25)
Pray for other’s healtha 26 (72.2) 9 (25)
Pray out loud while alonea 17 (47.2) 18 (50)
Pray quietly while alonea 30 (83.3) 5 (13.9)
a Missing data.
Time 2 qualitative questions
There were 5 questions asked in time 2. These
questions were answered by 7 participants. The first
question was, “when you were asked to say the
Serenity Prayer, was there anything about that
particular prayer that you thought of?” Five of the
participants answered this question. One participant
answered a simple no. Two of the participants thought
of God or of prayer, one stated how much they liked
the Serenity Prayer, and another discussed the
importance of continuing to recite the prayer after the
study was completed. One participant stated, “how
true all of it is. And to try and feel and believe the
Serenity part.” Yet another participant stated, “that it’s
my choice/free will to take meds and make right food
choices—If I lean on God through Jesus I will have
the strength to choose and I will make the right
one—health!”
The second question asked whether the Serenity
Prayer was added or substituted for the participants’
regular prayers. There were 8 respondents to this
TABLE 3. Serum Blood Glucose Results for
Participants Who Recited the Serenity Prayer
(N = 9)
ID Wk 1 Wk 2 Wk 3 Wk 4 Wk 5 Wk 6
1 101.0 105.7 108.0 108.2 110.5 110.0
7 114.3 141.7 237.2 189.7 191.7 139.2
8 253.3 253 195.7 144.7 199.7 194.7
14 182.3 390.7 166 198 262.7 252.2
15 210.3 223.3 155.5 226.5 394 272.5
18 138 104.5 108.8 125.3 124.3 88.3
26 333.3 222.5 304.5 166.5 283.8 318.5
28 143 220 116.3 176.8 186.8 147.8
36 162.7 140.8 125.8 160.3 157.8 147.8
question. A total of 6 added the prayer to their usual
prayers, while one substituted it.
The third question asked whether saying
the Serenity Prayer changed anything about the way
the participants were living their lives. There were
7 responses to this question. Three of the participants
answered “no” that it had not changed anything about
how they lived their lives. One participant answered,
“Yes, it made me feel more at peace, aware of
different situations, to think before acting upon, take
things slower, and open eyes.” Another participant
responded, “To accept the things I cannot change.”
A third participant wrote, “It made me remember
that there are some things I cannot change and some
I can. Sometimes I tend to forget, saying this everyday
made a difference.” Yet another participant recited the
Serenity Prayer daily at some point (other than related
to this study). A participant whose blood glucose levels
fell over the 6 weeks answered, “I mostly say it when
I am at work, it reminds me that nobody is obligated
to be nice to me—but I am obligated to be nice back.”
The fourth question asked: “do you feel like saying
the Serenity Prayer changed anything about the way
you were living with diabetes?” Five participants
stated that there was no change about the way they
were living with diabetes. Three of the participants
stated that they were stronger and more determined to
change and live a healthier life with, or as one
participant stated, “Free from diabetes.” It is
interesting to note that all of those citing strength had
no change in their serum blood glucose levels over the
6 weeks.
The fifth question was open-ended and asked
whether there was anything else anyone wanted to
share. One participant stated, “Yes, it made me more
aware of myself and situations and surroundings of
basic life, health, and responsibility. Being positive, I
can change anything with me.” A participant whose
blood glucose levels fell stated, “It made me more
aware of my health with diabetes.” A second
participant with blood glucose levels that fell stated,
“Usually I just check my glucose and say, ‘oh well,
ok’ and move on writing it down on paper. I’ve been
forced to realize just how bad it is getting.”
Time 3 qualitative question
In time 3, the following question was included: “do
you think that being in this study and checking your
blood glucoses the way you have been asked to do has
changed anything about you or your diabetes?” Six of
the 9 participants answered; 4 participants responded
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Use of the Serenity Prayer Among Adults With Type 2 Diabetes 197
that participation in the study had affected their diet,
exercise, and overall diabetes management. One
participant whose blood glucose levels fell over the
course of the study answered “yes, I changed the way
I eat and watch what I eat and how much and what to
eat and what not to eat.” Another participant whose
blood glucose levels also fell over time answered, “I
better start doing something about it fast, I justify and
rationalize a lot. Pretending I don’t have it doesn’t
mean I don’t have it.” Yet another participant added
that she or he felt that the study had given him or her
“a better routine and better guidelines to go by.” This
participant was one whose blood glucose levels did
not change during the course of the study.
DISCUSSION
This study was complicated by significant
implementation problems. It was proposed that a
sample of 60 with a 10% attrition rate would be
enrolled. Out of a total of 79 possible participants,
only 36 participants were enrolled and only 9
completed all phases of the study. Thus the statistical
analyses were limited to descriptive results.
Prayer, considered CAM, was used by 89% of the
study population. In the 2002 National Health
Interview Survey, results indicated that 47.6% of the
participants used prayer.14 In 2002, 47.6% of diabetic
patients reported that using CAM almost equaled to
the 47.9% of persons without diabetes. These
participants in the present study reported the use of
prayer at almost twice that of the general population in
the 2002 study.
Serum blood glucose results
For the 9 study participants, 4 showed no change in
serum blood glucose levels over 6 weeks, 3 had
increases in their serum blood glucose levels, and 2
had decreased levels. It is possible that to see a
significant drop in average serum blood glucose levels,
more than 6 weeks of data with the recitation of the
Serenity Prayer would be needed.
The Serenity Prayer was recited between 1 and 3
times a day for the 9 participants who recited it. This
small number of subjects does not allow for
generalizations nor are there any other studies on this
specific prayer for comparison.
Although the qualitative data in this study were
drawn from a small sample, the results are
encouraging for further research. Most of the
participants seem to have a greater understanding of
their diabetes as well as a greater sense of control over
their diabetes at the conclusion of the study. From the
qualitative data, those who participated in the study,
regardless of the Serenity Prayer recitation, indicated
that thought they had more control of their diabetes
and their lives.
Strength and limitations of the study
The strengths of this study were as follows: (a) the
setting provided excellent access to diabetic patients
with a variety of demographic characteristics, though
mostly low income; (b) the subjects are mostly
well-established consumers of health care at this site;
and (c) the recitation of the Serenity Prayer does not
assume any specific religious affiliation. Study
limitations were as follows: (a) enrollment numbers
were low and attrition was extremely high and (b)
multiple variables such as the effect of other prayers or
religious practices were not controlled for.
Recommendations for further research
There are several components of this study that raised
questions for future research. While the Serenity
Prayer is popular among individuals of all religious
backgrounds, no previous research was found that
addressed health outcomes of this prayer use.
Furthermore, in this study, the only instruction that the
participants were given was to recite the prayer at least
once daily. In retrospect, we could have been more
specific about the conditions under which the prayer
was recited, for example, in a quiet place, at rest. We
also could have asked the participants to record the
conditions under which they recited the prayer, thus
providing rich qualitative data for future research. We
underestimated the challenges inherent in research
with the study group, a group that is not used to
participating in longitudinal studies. Additional
incentives could have been included to maintain the
involvement of the participants, and this is
recommended for future research. This study should
be replicated with a larger sample and longitudinal
assessments of physiological and psychological
variables should be obtained. The possibilities of
further research using the Serenity Prayer are vast,
with application to any patient population.
Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
198 HOLISTIC NURSING PRACTICE • JULY/AUGUST 2011
REFERENCES
1. DiJoseph J, Cavendish R. Expanding the dialogue on prayer relevant to
holistic care. Holist Nurs Prac. 2005;19(4):147-155.
2. O’Connor PJ, Pronk NP, Tan A, Whitebird RR. Characteristics of
adults who use prayer as an alternative therapy. Am J Health Prom.
2005;19(5):369-375.
3. Watkins K, Connell CM. Measurement of health-related
QOL in diabetes mellitus. Pharmacoeconomics. 2004;22(17):
1109-1126.
4. Aljasem LI, PeyrotM,Wissow L, Rubin RR. The impact of barriers and
self-efficacy on self-care behaviors in type 2 diabetes. Diabetes Educ.
2001;27(3):393-404.
5. Hodge DR. A systematic review of the empirical literature on intercessory
prayer. Res Soc Work Prac. 2007;17(2):174-187.
6. Jones RA, Utz S, Wenzel J et al. Use of complementary and alternative
therapies by rural African Americans with type 2 diabetes. Alt Ther
Health Med. 2006;12(5):33-38.
7. Taylor EJ. Prayer’s clinical issues and implications. Holist Nurs Prac.
2003;17(4):179-188.
8. Tolson CL, Koenig HG. The Healing Power of Prayer: The Surprising
Connection Between Prayer and Your Health. Grand Rapids,MI: Baker
Books; 2003.
9. Aviles JM, Whelan SE, Hernke DA et al. Intercessory prayer and
cardiovascular disease progression in a coronary care unit population:
a randomized controlled trial. Mayo Clin Proc. 2001;76(12):
1192-1198.
10. Cha KY, Wirth DP, Lobo RA. Does prayer influence the success of
in vitro fertilization-embryo transfer? Report of a masked, randomized
trial. J Reproduc Med. 2001;46(9):781-787.
11. Palmer RF, Katerndahl D, Morgan-Kidd J. A randomized trial of the effects
of remote intercessory prayer: interactions with personal beliefs on
problem-specific outcomes and functional status. J Altern Complement
Med. 2004;10(3):438-448.
12. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary
and alternative medicine use among adults: United States, 2002. Adv
Data. 2004;(343):1-19.
13. Saydah SH, Eberhardt MS. Use of complementary and alternative
medicine among adults with chronic diseases: United States 2002. J
Altern Complement Med. 2006;12(8):805-812.
14. Garrow D, Egede LE. National patterns and correlates of complementary
and alternative medicine use in adults with diabetes. J Altern Complement
Med. 2006;12(9):895-902.
15. Yeh GY, Eisenberg DM, Davis RB, Phillips RS. Use of complementary
and alternative medicine among persons with diabetes mellitus: results
of a national survey. Am J Pub Health. 2002;92(10):1648-1652.
16. Frank J, Blok TM, Carter JA, Mullen L, Tideman AM, Parkes JL. Performance
and ease of use of Breeze2 blood glucose monitoring system.
In: Bayer Health Care Clinical Trial Report. Leverkusen, Germany:
Bayer Health Care Communications; 2007.