Background Few studies have examined complementary medicine (CM) use in diabetes. Australian data are inconsistent, limited in scope and have not considered cost. Aims To evaluate the prevalence, associates and costs of CM in a contemporary Australian urban, community‐based cohort of people with type 2 diabetes. Methods Baseline CM use was determined as part of a detailed assessment in 1543 of 1551 Fremantle Diabetes Study Phase II (FDS2) participants with type 2 diabetes (mean age 65.7 years, 51.8% males, median diabetes duration 9.0 years) recruited to the FDS2 between 2008 and 2011 who self‐reported medication use including CM defined as non‐prescription medicinal products. Results A total of 672 FDS2 type 2 participants (43.6%) used at least one type of CM, 92% of which were nutritional supplements (omega‐3 fatty acids/fish oil in 24% of CM users followed by calcium in 11%, glucosamine in 10% and others in <10%). Independent associates of CM use included older age, female sex, any mobility problem, and, inversely, Southern European or Indigenous Australian background, lack of English fluency, ex/current smoking status, taking oral glucose‐lowering medications and higher HbA1c. The total annual estimated cost of CM used by FDS2 participants with type 2 diabetes was A$121 640 or A$79 ± 208 per person (range A$0–2993). Extrapolating these data, the 1 million Australians with type 2 diabetes spend A$79 million/year on CM. Conclusions CM use in type 2 diabetes is both common and costly. Healthcare professionals should consider discussing safe and cost‐effective use of CM with their patients with type 2 diabetes.

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