Diabetes has been recorded in the annals of medical history since ancient Egyptian times when the papyrus of Ebers dated at 1550 BC recommended dietary remedies for those passing abundant urine. Early Sanskrit and Roman literature also included references to 'honeyed urine' and a 'mysterious affection' where thirst was unquenchable and death inevitable (Bloom and Ireland, 1980). Although many researchers have theorized about the cause of the illness, diabetes remains a mysterious and debilitating disease with an unknown etiology (Trucco and Donnan, 1989).
Diabetes mellitus is defined as a chronic disorder which is characterized by an elevated level of glucose in the blood due primarily to inadequate secretion or utilization of insulin (Bloom and Ireland, 1980). In nearly every early text book or treatise on diabetes, diet was stated to be the cornerstone of treatment (Nuttall, 1983). The discovery of insulin by Dr. Frederick Banting and Charles Best in 192 1, however, completely revolutionized the treatment of diabetes and was hailed as one of the greatest medical triumphs of the twentieth century.
Since the time of Banting and Best, therapy for diabetes mellitus, especially type I (insulin-dependent) diabetes, has changed rapidly. The most important new developments are the synthesis of nonimrnunogenic insulin and the introduction of portable blood glucose meters (PBGM). The recent advent of PBGM has allowed diabetes mellitus patients to accurately monitor their own blood glucose levels on a daily basis and has been called the single most significant advancement in diabetes management since the discovery of insulin (Watts and Keffer, 1989). Current research strongly supports the concept that the debilitating sequelae often associated with diabetes mellitus-such as vascular disease, retinopathy, nephropathy, and neuropathy can be curtailed by careful daily metabolic control of blood glucose levels (Brownlee and Cahill, 1979; Cahill et al., 1976; Camarin-Davilos et al., 1983; Jackson et al., 1982a; Jackson et al., 1982b; Raskin et al., 1983; Tchobroutsky, 1978).
In the past, blood glucose levels were determined by an occasional urine test or laboratory analysis of blood plasma conducted once every few weeks or months (Guthrie et al., 1986). Physicians have long recognized that such periodic testing offered only a crude estimate of glycemic control due to the fact that blood glucose concentrations change rapidly in diabetic patients (Bruckel et al., 1990). Recent studies performed on PBGM under closely controlled conditions in diabetic units have demonstrated that reflectance meters give reliable quantitative estimates of venous glucose concentrations (Clements et al., 1981; Reeves et al., 1981; Shapiro et al., 198 1; Steinbeck et al., 198 1; Worth et al., 198 1). Although measurements of blood glucose concentrations using PBGM are not as scientifically precise as those performed on state-of- the-art, clinical laboratory analyzers, they are nevertheless easy to perform and sufficiently accurate to allow the patient to make daily adjustments in their insulin dose. While the literature is replete with evaluations of PBGM (Clarke et al., 1987; Hunt and Alojado, 1989; North et al., 1987), the Accu Chek model is considered one of the most accurate and convenient to use (Aziz and Hsiang, 1983; Brooks et al., 1986). The Accu-Chek I11 reflectance meter was therefore utilized in the current study as a reliable means by which patients could monitor their daily blood glucose concentrations and thereby adjust their daily insulin dosage accordingly.
The purpose of this exploratory pilot study was to examine the combined effect of Therapeutic Touch therapy and Intercessory Prayer on the insulin dose levels of IDDM patients. The theoretical premise evaluated was whether the implementation of these complementary healing therapies would result in an alteration in patient administered insulin dosage. The Therapeutic Touch method utilized in this study is based on the ancient healing practice of laying on of hands and was originally conceptualized by Dr. Dolores Krieger as an adjunct to traditional medical care (Heidt, 1991 ; Krieger, 1990; Krieger et al., 1979). Therapeutic Touch is based on a theory of energy transfer wherein the practitioner is said to direct healing energy through their hands to the patient for the purpose of helping or healing (Krieger, 1979). Prior research has indicated that Therapeutic Touch is effective in increasing the regeneration rate of salamander forelimbs (Wirth et al., 1992), accelerating human dermal wound repair (Wirth, 1990; Wirth et al., 1993a), reducing pain (Keller, 1983; Keller and Bzdek, 1986), anxiety (Heidt, 198 1; Quinn, 1982, 1984), and decreasing overall muscle tension as evaluated by multi-site surface electromyographic analysis (Wirth and Cram, 1993). Intercessory Prayer, on the other hand, is not based on a theory of energy interaction between healer and subject but, rather, is a traditional religious healing practice which is a fundamental component of virtually all societies andreligions of the world (Byrd, 1988; Spivak, 1917; Wirth, 1993). In the west, prayer healing formally began with the ordained rites and rituals of early Christianity (Dossey, 1993; Frost, 1949). Modem medical literature, however, contains only a few scientific studies on the therapeutic efficacy ofprayer (Byrd, 1988; Collipp, 1969; Joyce and Welldon, 1965). The most notable of these studies is a randomized double-blind experiment which demonstrated that patients in a coronary care unit who received the benefit of Intercessory Prayer had a significantly reduced requirement for antibiotics, diuretics, and ventilatory support as compared to the control group (Byrd, 1988; Wirth, 1993).
Complementary healing has become increasingly popular in the United States and Europe and is normally performed in one of two ways: (1) by the laying on of hands, and (2) by healing at a distance in which healing occurs through thought or energy projection (Attevelt, 1988; Beutler et al., 1988; Eisenberg et al., 1993; Fulder and Munro, 1985; Reilly, 1983; Wirth et al, 1993b). Therapeutic Touch therapy generally utilizes the laying on of hands approach, though often without physical contact-i.e., Noncontact Therapeutic Touch (NCTT)-whereas Intercessory Prayer is routinely performed at a distance from the patient. Prior research on complementary healing methods has demonstrated that up to 85% of patients who visit complementary healers claim to experience an improvement in their condition (Attevelt, 1988; Wirth, 1987, 1994). To our knowledge, however, no experimental data are available on whether complementary healing approaches such as Therapeutic Touch or Intercessory Prayer result in a measurable improvement for diabetes mellitus patients. Therefore, the following double-blind, within subject, crossover study was conducted in order to investigate the influence of Therapeutic Touch therapy and Intercessory Prayer in combination on the insulin dosage of type I diabetes mellitus patients.
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