Factors associated with non-adherence to insulin and non-insulin medications in patients with poorly controlled diabetes

Objectives To evaluate differences in factors associated with self-reported medication non-adherence to insulin and non-insulin medications in patients with uncontrolled type 2 diabetes. Methods In this secondary analysis of a randomized trial in patients with obesity and uncontrolled type 2 diabetes, multivariable logistic regression was used to evaluate associations between several clinical factors (measured with survey questionnaires at study baseline) and self-reported non-adherence to insulin and non-insulin medications. Results Among 263 patients, reported non-adherence was 62% (52% for insulin, 55% for non-insulin medications). Reported non-adherence to non-insulin medications was less likely in white versus non-white patients (odds ratio (OR) = 0.42; 95%CI: 0.22,0.80) and with each additional medication taken (OR = 0.75; 95%CI: 0.61,0.93). Non-adherence to non-insulin medications was more likely with each point increase in a measure of diabetes medication intensity (OR = 1.43; 95%CI: 1.01,2.03), the Problem Areas in Diabetes (PAID) score (OR = 1.06; 95%CI: 1.02,1.12), and in men versus women (OR = 3.03; 95%CI: 1.06,8.65). For insulin, reporting non-adherence was more likely (OR = 1.02; 95%CI: 1.00,1.04) with each point increase in the PAID. Discussion Despite similar overall rates of reported non-adherence to insulin and non-insulin medications, factors associated with reported non-adherence to each medication type differed. These findings may help tailor approaches to supporting adherence in patients using different types of diabetes medications.

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Clinical factors associated with the recovery of cardiovascular autonomic neuropathy in patients with type 2 diabetes mellitus

Cardiovascular Diabetology ◽

10.1186/s12933-019-0830-4 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 4

Author(s):

Ji Eun Jun ◽

Seung-Eun Lee ◽

Min Sun Choi ◽

Sung Woon Park ◽

You-Cheol Hwang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Autonomic Neuropathy ◽

Cardiovascular Autonomic Neuropathy ◽

Clinical Factors ◽

Factors Associated

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CLINICAL FACTORS ASSOCIATED WITH SUDDEN CARDIAC DEATH IN TYPE 2 DIABETES: INSIGHTS FROM THE SAVOR-TIMI 53 TRIAL

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)32084-8 ◽

2016 ◽

Vol 67 (13) ◽

pp. 2083 ◽

Cited By ~ 1

Author(s):

Ilaria Cavallari ◽

Ravi Patel ◽

Deepak Bhatt ◽

Philippe Steg ◽

Lawrence Leiter ◽

...

Keyword(s):

Type 2 Diabetes ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Clinical Factors ◽

Factors Associated

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Network Meta-Analysis of Novel Glucose-Lowering Drugs on Risk of Acute Kidney Injury

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.11220720 ◽

2020 ◽

Vol 16 (1) ◽

pp. 70-78 ◽

Cited By ~ 1

Author(s):

Min Zhao ◽

Shusen Sun ◽

Zhenguang Huang ◽

Tiansheng Wang ◽

Huilin Tang

Keyword(s):

Type 2 Diabetes ◽

Confidence Interval ◽

Odds Ratio ◽

Lower Risk ◽

Meta Analysis ◽

Secondary Analysis ◽

Sglt2 Inhibitors ◽

Glucose Lowering ◽

Event Driven

Background and objectivesLittle is known about the comparative effects of dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), or sodium glucose cotransporter-2 (SGLT2) inhibitors on risk of AKI. This study aimed to compare the effects of these three novel classes of glucose-lowering drugs on AKI risk in patients with or without type 2 diabetes, by network meta-analysis of event-driven cardiovascular or kidney outcome trials.Design, setting, participants, & measurementsWe systematically searched electronic databases up to September 2020, and included 20 event-driven cardiovascular or kidney outcome trials (18 trials included patients with type 2 diabetes only, and two trials included patients with or without type 2 diabetes). A network meta-analysis using a frequentist approach was performed to compare the effects of DPP-4 inhibitors, GLP-1RAs, or SGLT2 inhibitors on risk of AKI, and estimate the probability for each intervention as the safest one. The primary analysis included 18 trials with type 2 diabetes only, and a secondary analysis included 20 trials.ResultsIn the 18 trials with a total of 2051 AKI events (range: 1–300) among 156,690 patients with type 2 diabetes only, our network meta-analysis showed that SGLT2 inhibitors were associated with a lower risk of AKI compared with placebo (odds ratio, 0.76; 95% confidence interval, 0.66 to 0.88), whereas both DPP-4 inhibitors and GLP-1RAs had neutral effects on risk of AKI. Moreover, SGLT2 inhibitors were significantly associated with a lower risk in AKI than both GLP-1RAs (odds ratio, 0.79; 95% confidence interval, 0.65 to 0.97) and DPP-4 inhibitors (odds ratio, 0.68; 95% confidence interval, 0.54 to 0.86). SGLT2 inhibitors have the highest probability of being the safest intervention (84%). The results were similar in the secondary analysis.ConclusionsCurrent evidence indicates that SGLT2 inhibitors have a lower risk of AKI than both DPP-4 inhibitors and GLP-1RAs.

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Prevalence and Correlates of Musculoskeletal Pain in Adults with Type 2 Diabetes in Populations with Low-Risk of Obesity: A Cross- Sectional Study

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.13 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Adedapo W Awotidebe ◽

Auwalu Shehu

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Musculoskeletal Pain ◽

Odds Ratio ◽

Activity Level ◽

Low Risk ◽

Point Prevalence ◽

Cross Sectional ◽

Factors Associated

BACKGROUND፡ There are few data concerning the prevalence and predictors of musculoskeletal pain among adults with type 2 diabetes in population with low-risk of obesity. Our objective was to describe the point prevalence and factors associated with increased risk of musculoskeletal pain in this population.METHODS: A cross-sectional data of 200 adults with type 2 diabetes, aged ≥ 18 years who were attending two tertiary hospitals were examined. Musculoskeletal pain and physical activity were collected with Nordic Musculoskeletal Questionnaire (NMQ) and International Physical Activity Questionnaire (IPAQSF) respectively. We used logistic regression to examine the risks associated with musculoskeletal pain.RESULTS: The point prevalence of musculoskeletal pain was 72.7% and similar between men (72.3%) and women (73.1%). In the last 7days, advancing age (odds ratio=1.09;95%CI:1.02-1.16) and comorbidity (odds ratio=3.0;95%CI:1.07-8.39) were risk factors associated with musculoskeletal pain. In the last 12 months, only comorbidity (odds ratio=5.57;95%CI:1.62-19.17) was a risk factor for increasing musculoskeletal pain. However, a unit increase in physical activity level (odds ratio=0.06;95%CI:0.008-0.51) was associated with decreased odds of musculoskeletal pain.CONCLUSIONS: The prevalence of musculoskeletal pain was high and physical activity was associated with a decreased risk thereof. A further research should be evaluated on the influence of physical activity on musculoskeletal pain.

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