Comparative Study of Medication Adherence and Glycemic Control in Type 2 Diabetes Mellitus Patients on Oral Hypoglycemics versus Insulin Therapy.

BACKGROUND

Adherence to medication is a critical factor that affects the glycemic control in patients with type 2 diabetes mellitus (T2DM) and influences both short-term and long-term complications. The objective of the study was to assess the impact of medication adherence and glycemic control in patients with T2DM on oral hypoglycemic agents (OHAs) and insulin.

MATERIALS AND

METHODS

This 12-month prospective study involved 220 T2DM patients at a tertiary care hospital. The study cohort was divided into those on OHAs (n = 120) and insulin therapy (n = 100). Adherence was measured by the Morisky Medication Adherence Scale, and glycemic control was measured by levels of glycated hemoglobin (HbA1c).

RESULTS

The average age of the participants was 55.2 ± 11.8 years, and males were overrepresented (60%). Adherence was high among 68% of patients receiving OHAs and 52% of those receiving insulin (P = 0.02). The average HbA1c was lower in the OHA group (7.4% ±1.1%) than in the insulin group (8.2% ± 1.4%, P < 0.001). Glycemic control was also better in patients with high adherence (HbA1c 7.1% ± 0.9%) than low adherence (8.6% ± 1.3%, P < 0.001). Complexity of treatment, dose frequency, and injection fear were some factors that affected adherence in the insulin group.

CONCLUSION

This study demonstrates that adherence is higher in patients treated with OHA and that it is associated with better glycemic control. Interventions to improve adherence in the insulin group are crucial for better management of diabetes.