Saratov JOURNAL of Medical and Scientific Research

Adherence to recommendations and effectiveness of glucose-lowering treatment in type 2 diabetes patients receiving insulin based in the Nizhny Novgorod region on data of mobile diagnostic and therapeutic centre "Diabetes mellitus"

Year: 2016, volume 12 Issue: №1 Pages: 71-76
Heading: Endocrinology Article type: Original article
Authors: Panova S.Yu., Petrov A.V., Strongin L.G.
Organization: N. Novgorod State Medical Academy

Adherence to treatment is an important factor in diabetes management. Poor adherence may cause ineffective control, especially in insulin-treated patients. Aim of the study: to evaluate the adherence to nutrition, physical activity and self-monitoring in T2DM patients who do and do not receive insulin treatment. Materials and methods. 550 T2DM patients were examined as a part of mobile diabetes center in different areas of the Nizhny Novgorod region. Clinical examination results, HbA1c, creatinine and microalbuminuria were assessed. Adherence to treatment was evaluated by questionnaire Diabetes Self-Care Activities. Results. Insulin-treated patients had longer diabetes duration and worse HbA1 с level and similar levels of adherence related to diet, physical activity, foot care. Only for glucose self-monitoring was adherence higher. Best HbA1c values were observed in patients with adherence in middle region of 3-5 days. Conclusion. Long diabetes duration and worse glycemic control in insulin-treated T2DM patients is not associated with better adherence to treatment. This may be viewed as evidence on insufficient patients education and can be a potential target for improvement of glycemic control.

1. Khaw KT, Wareham N, Bingham S, et al. Association of hemoglobin a1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk. Ann Intern Med 2004, Sep 21; 141 (6): 413-420 WHO 2011: Global Atlas on CVD prevention and control. P. 1-164
3. Shestakova M.V. Efficacy and safety of treatment with human insulin analogues in daily management of insulin naive patients with type 2 diabetes mellitus: results of multicenter 52-week observational study A1 chive. Diabetes mellitus 2012; (4): 115-121
4. UK Prospective Diabetes Study (UKPDS) Group: UKPDS Intensive blood-glucose control with sulphonyiureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998, Sep 12; 352 (9131): 837-853
5. Riedel AA, Heien H, Wogen J, et al. Loss of glycemic control in patients with type 2 diabetes mellitus who were receiving initial metformin, sulfonylurea, or thiazolidinedione monotherapy. Pharmacotherapy 2007, Aug; 27 (8): 1102-1110
6. Inzucchi SE, Bergenstal RM, Buse JB,etal. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach: Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2012; 55 (6): 1577-1596
7. International Diabetes Federation: Global Guideline for Type 2 Diabetes: ClinicalGuidelines Task Force, 2012. URL: br/media/uploads/idf_t2dm_ guideline.pdf
8. Garber AJ, Abrahamson MJ, Barzilay Jl, et al. American Association of Clinical Endocrinologists' Comprehensive Diabetes Management Algorithm 2013 Consensus Statement. Endocrine Practice 2013; 19 (s2): 327-336
9. Dedov I.I., Shestakova M.V., Ametov A.S., et al. Consensus council of the Russian Association of endocrinologists on initiation and intensification of glucose-lowering therapy patients with type 2 diabetes mellitus. Diabetes mellitus 2011; (4): 6-17
10. Dedov I.I., Shestakova M.V., eds. Standards of specialized diabetes care (6th edition). Diabetes mellitus 2013; (1S): 1-121
11. Petrov A.V., Kalinnikova A.A., Strongin L.G., etal. Connection type of glucose-lowering therapy and level of compensation for type 2 diabetes mellitus as a result of mobile-center. Diabetes mellitus 2012; (2): 32-37
12. Kalashnikova M.F., Bondarev I.B., Lihodey N.V. Commitment to the treatment in 2nd type diabetes mellitus: definition of the notion, modern methods of the treatment assessment by the patients. Lechashchiy vrach 2015; (3): 27-33
13. World Health Organization: Adherence to long-term therapies: evidence for action. 2003. URL: chp/knowledge/publications/adherence_full_report.pdf
14. Haynes RB, McDonald H, GargAX, etal. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev 2002: CD000011
15. Ware JE, Kosinski M, Turner-Bowker DM, et al. User's Manual for the SF-12v2® Health Survey (Wth a Supplement Documenting SF-12® Health Survey). Boston, Massachusetts, 2009; p. 29-56
16. Craid CL, Marshall AL, Sjostrom M, et al. International Physical Activity Questionnaire: 12-Country Reliability and Validity. Medicine & Science in Sports & Exercise 2003: 1381 — 1395
17. SibaiAM, etal. Physical activity in adults with and without diabetes: from the 'high-risk' approach to the 'population-based' approach of prevention. ВМС Public Health 2013; (13): 1002
18. Toobert DJ, Hampsone SE, Glasgow RE. The Summary of Diabetes Self-Care Activities Measure Results from 7 studies and a revised scale. Diabetes Care 2000; (23): 943-950.

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