most chiropractors today. Such a deﬁnition carries the risk of loss of scope. There is no evidence that any
other profession has improved public and professional acceptance, growth and cultural authority by
contracting their scope or deﬁnition of practice. Rather there is evidence to the contrary.
Conservative care of the extremities, speciﬁcally manual therapy, continues to be an unmet need and
demand by patients and yet is an integral service primarily provided by chiropractors. Though research and
study of manual therapy for peripheral disorders has exploded, chiropractors still remain the primary
providers of this service. Furthermore, the historical record ﬁnds no evidence of (previous) non-medical and
limited licensed professionals increasing their acceptance, scope and utilization by reducing their scope or
deﬁnition of their scope.
Conclusions: This commentary offers arguments and evidence that there is an increasing and unmet demand
by patients for extremity care with a concurrent intensiﬁed interest in diagnosis, treatment and research by
chiropractors and other professionals. There are better deﬁnitions that protect the interests of patients who
demand this care, such as ‘‘chiropractors are doctors who specialize in nonsurgical spine and extremity care’’
and/or ‘‘chiropractors are doctors who specialize in the care of nonsurgical spine and joint disorders’’.
Functional medicine and chiropractic: A case series in Type 2 Diabetes Mellitus reversal
Stephanie Chaney, Tom Chaney, Paul A. Oakley *
E-mail address: email@example.com
Introduction: Diabetes Mellitus (DM) is a syndrome characterized by hyperglycemia resulting from absolute/
relative impairment in insulin secretion and/or insulin action. Type II DM (T2DM) usually affects adults >30
years and affects 23.6 million Americans; another 57 million are pre-diabetic. The current standard of care
for T2DM includes oral medications, insulin injections, and general lifestyle and nutritional advice. Con-
ditions associated with T2DM include obesity, hypertension, hyperlipidemia, pancreatitis and hypothyroid-
ism. Complications include neuropathy, heart disease, stroke, kidney failure, blindness, and death.
Typically, recommendations given to a T2DM patient are only general. Considering that dietary choices are
a statistically proven factor in the incidence of developing T2DM and that perhaps as low as one-quarter of
patients follow dietary measures, we hypothesized that with a comprehensive, individualized functional
medicine (FM) and chiropractic treatment plan, T2DM patients could reduce and/or eliminate use of
medication and reverse their disease. This case series involves the treatment of four, previously MD-
diagnosed, T2DM patients taking diabetes-speciﬁc medication.
Methods: Initial exam included blood work, health/neurological questionnaires, hormone testing, adrenal
gland testing and an expanded gastrointestinal panel. During treatment, blood markers including a full lipid
panel, glycosylated hemoglobin (HbA1c), liver enzymes, vitamin D, and others were monitored every 6—8
Treatment plans of FM (speciﬁc nutritional and lifestyle consulting, nutritional supplementation, detox-
iﬁcation) and chiropractic manipulation were recommended to correct biomechanical and biochemical
imbalances, nutritional deﬁciencies, presence of parasites and infections as possible causes/contributors to
elevated blood sugar levels. The patients were referred back to their prescribing physician for follow-up as
necessary to have their medications adjusted/eliminated.
Results: Four T2DM patients (2 female, 2 male) having an average age of 65 yrs (range 57—73 yrs), average
weight of 209.4 lbs (172—280 lbs), average pre-treatment and pharmacologically maintained glycosylated
hemoglobin of 6.25% (5.3—8.0% HbA1c) consented to a functional medicine and chiropractic program (5—9
months duration). All were overweight/obese, and all were on multiple medications for diabetes and other
All 4 patients achieved a reversal of their diabetic conditions and were able to maintain normal
glycosylated hemoglobin levels (HbA1c) without use of any oral medication or insulin. On average, the
group lowered their HbA1c 0.5%, one patient dropped from 8.0% with 90 units of insulin to 5.9% without
insulin in 6 months. All patients lost weight, on average 39 lbs, one patient lost 56 lbs in 5 months.
FM consultations started semiweekly, tapering to semimonthly, chiropractic was on a semimonthly basis.
One patient received chiropractic 3!/week during their program. No speciﬁc exercise regimens were
recommended other than walking; one patient did vibration plate exercises for 15 min, 3!/week.
Abstracts from the WFC’s 11th Biennial Congress 147
Discussion: Diet and lifestyle factors are a vital factor in the establishment and therefore the reversal of
T2DM. The Merck Manual suggests diet to achieve weight reduction is most important in overweight patients
with Type II DM. Since all four patients were overweight and all lost signiﬁcant weight on their programs, this
undoubtedly played an important part in the reestablishment in normal physiological blood markers
Conclusion: This study demonstrates the efﬁcacy of natural means with which to reverse T2DM.
Difﬁculties in entering clinical practice
´bio Dal Bello *, Luis Costa Cantera
E-mail address: firstname.lastname@example.org
Introduction: When starting clinical practice, students in the health arena face many difﬁculties within the
scope of patient therapy. Unlike theoretical learning, which is proving increasingly effective in introducing
the student to problem-based learning and performing tests in groups, to learn clinical practice requires
venturing beyond theoretical knowledge to develop practical skills associated with the psychological factors
that inﬂuence the student’s conduct when attending a patient. This study aimed to verify the causes and the
prevalence of difﬁculties presented by chiropractic students when starting their clinical practice; verify the
most used chiropractic technique as well as identify those that are more difﬁcult to implement in the
beginning of clinical performance.
Methods: This study was performed with 39 chiropractic students enrolled in the chiropractic course from
a college in southern Brazil, who were beginning clinical practice within the chiropractic curriculum of the
institution. A questionnaire was given to the students with questions related to their difﬁculties in starting to
attend a patient with the aim of verifying the causes and prevalence of these difﬁculties when starting the
practical learning process.
Results: The ﬁrst questions given to the students referred to their difﬁculties when starting to attend
patients, and clinical information submitted by those who are seeking chiropractic care. The question
presented by the students which gave them most difﬁculty was uncertainty in making the correct decision,
with 69.2% of the answers. The students reported that they considered insufﬁcient knowledge (12.8%) was
the second most prevalent cause regarding their difﬁculties. For decision-making in clinical care, the
students considered that their main difﬁculties related to the inability to conduct safe pathological diagnosis
(53.8%) and insufﬁcient knowledge to conduct the laboratory analysis of the patient’s condition (23.1%). The
students also answered questions related to their ability and difﬁculties in performing different chiropractic
techniques, and the Gonstead Cervical Chair (56.4%) and Gonstead SHC lumbar (53.8%) have shown greater
Discussion: Many learning techniques are searching to promote education productivity increasingly
signiﬁcant to the students needs, especially regarding to clinical uncertainties and decision making;
however, the reality has shown that when starting clinical practice, the students will always have some
difﬁculty in carrying out their activities.
Conclusion: It is concluded that by providing didactic teaching in addition to theoretical and practical
knowledge, thus stimulating the students, knowledge and understanding of the patient in physical and
psychological range, the difﬁculties regarding the ﬁrst clinical attendance could be minimized. It is also
concluded that the creation of methods that provide practice of all techniques taught in chiropractic
curriculum and their knowledge and interdisciplinary clinical relationship may promote the formation of
students who are more conﬁdent and able to act professionally.
148 Abstracts from the WFC’s 11th Biennial Congress