Endocrine Abstracts

Introduction: Treatment adherence is fundamental in diabetes control. The aim of our study is to evaluate treatment adherence in patients with type 2 diabetes and to determine its associated factors.

Methods: Cross-sectional study enrolling 80 type 2 diabetes patients followed up in the outpatient department of the national institute of nutrition. The Morisky questionnaire was used to evaluate treatment adherence. Age, gender, body mass index (BMI), diabetes duration and treatment, glycosylated hemoglobin (HbA1c), serum lipid profile, microvascular and macrovascular complications were assessed.

Results: The mean age was 60 ± 8 years. Of the study population, 60% were females. and 65% were insulin-treated. The mean diabetes duration was 14.9 ± 7.7 years, mean glycated hemoglobin was 10.4% ± 1.6 and mean BMI was 30.1 ± 6.2 Kg/m^². High adherence was reported in 37% of cases, medium adherence in 28% of cases and low adherence in 35% of cases. Patients with good adherence had higher BMI (31.74 ± 6.7 Kg/m^² vs 27.99 ± 5.55 Kg/m^²;P = 0.03) and better serum lipid profile including a lower triglycerides levels (1.94 ±1.11 mmol/l vs 1.3± 0.52 mmol/l; P = 0.003). Lower HbA1c levels (10.89%± 1.4 vs 10.42% ±1.5; P = 0.25), lower total cholesterol levels (4.08 mmol/l ±1.06 vs 4.47 mmol/l ± 1; P = 0.17) and higher HDL cholesterol levels (1.14 ±0.32 vs 1.02 ±0.2; P = 0.13) were associated to a better adherence but not significant. The presence of peripheral neuropathy, gastroparesis and genital autonomic neuropathy were significantly associated with low adherence (P = 0.015, P = 0.007 and P = 0.02 respectively). Patients with good adherence had lower prevalence of macrovascular complications including acute coronary syndrome (15.4% vs 35%; P = 0.1), stroke (4.8% vs 7.7%; P = 0.6) and peripheral arterial disease (38.5% vs 52.4%; P = 0.2).

Conclusions: Our study highlights the beneficial impact of good adherence on lipid, and glycemic control. More awareness campaigns and counseling services should be provided by health professionals to improve treatment adherence and diabetes management.