AIMS: To analyse predictors of glycaemic control including medication adherence and body mass index (BMI) in UK general practice patients with sub-optimally controlled type 2 diabetes. METHODS: Baseline demographic, health- and treatment-related measures were evaluated as predictors of one year glycaemic control defined separately as HbA(1c)≤ 7.5% and a continuous measure of HbA(1c) concentration, using multivariate regression models. Significant predictors were adjusted for objectively assessed medication adherence and BMI. RESULTS: One-year HbA(1c) concentration was associated with baseline HbA(1c) (p<0.001), BMI (p=0.02), and inversely associated with age (p=0.007) and objectively assessed adherence. Adherent patients had one-year (adjusted) HbA(1c) concentration 0.65% (95% CI -1.04, -0.25; p=0.001) lower than nonadherent. Odds ratios (95% CI) of HbA(1c)≤ 7.5% for 10-year higher age were 1.63 (1.08, 2.45); for adherent compared to non-adherent patients 1.89 (0.84, 4.25); for patients receiving >5 compared to ≤ 5 medications 0.32 (0.13, 0.76); and for each 1% increment in baseline HbA(1c) 0.48 (0.31, 0.73). CONCLUSIONS: The lower HbA(1c) achieved from greater adherence to glucose lowering treatment is comparable to that achieved with additional medication. Relationships between older age and better glycaemic control are not explained by better adherence, but may partly relate to lower BMI.
AIMS: To analyse predictors of glycaemic control including medication adherence and body mass index (BMI) in UK general practice patients with sub-optimally controlled type 2 diabetes. METHODS: Baseline demographic, health- and treatment-related measures were evaluated as predictors of one year glycaemic control defined separately as HbA(1c)≤ 7.5% and a continuous measure of HbA(1c) concentration, using multivariate regression models. Significant predictors were adjusted for objectively assessed medication adherence and BMI. RESULTS: One-year HbA(1c) concentration was associated with baseline HbA(1c) (p<0.001), BMI (p=0.02), and inversely associated with age (p=0.007) and objectively assessed adherence. Adherent patients had one-year (adjusted) HbA(1c) concentration 0.65% (95% CI -1.04, -0.25; p=0.001) lower than nonadherent. Odds ratios (95% CI) of HbA(1c)≤ 7.5% for 10-year higher age were 1.63 (1.08, 2.45); for adherent compared to non-adherent patients 1.89 (0.84, 4.25); for patients receiving >5 compared to ≤ 5 medications 0.32 (0.13, 0.76); and for each 1% increment in baseline HbA(1c) 0.48 (0.31, 0.73). CONCLUSIONS: The lower HbA(1c) achieved from greater adherence to glucose lowering treatment is comparable to that achieved with additional medication. Relationships between older age and better glycaemic control are not explained by better adherence, but may partly relate to lower BMI.
Authors: Cheryl L P Vigen; Kristine Carandang; Jeanine Blanchard; Paola A Sequeira; Jamie R Wood; Donna Spruijt-Metz; Robin Whittemore; Anne L Peters; Elizabeth A Pyatak Journal: Diabetes Educ Date: 2018-10-08 Impact factor: 2.140
Authors: Becca S Feldman; Chandra J Cohen-Stavi; Morton Leibowitz; Moshe B Hoshen; Shepherd R Singer; Haim Bitterman; Nicky Lieberman; Ran D Balicer Journal: PLoS One Date: 2014-09-26 Impact factor: 3.240
Authors: C McAdam-Marx; B K Bellows; S Unni; J Mukherjee; G Wygant; U Iloeje; J N Liberman; X Ye; F J Bloom; D I Brixner Journal: Int J Clin Pract Date: 2014-08-12 Impact factor: 2.503
Authors: Oladele Vincent Adeniyi; Parimalaranie Yogeswaran; Benjamin Longo-Mbenza; Daniel Ter Goon; Anthony Idowu Ajayi Journal: BMJ Open Date: 2016-07-29 Impact factor: 2.692
Authors: G A Nichols; A G Rosales; T M Kimes; K Tunceli; K Kurtyka; P Mavros; J F Steiner Journal: Diabetes Obes Metab Date: 2015-05-20 Impact factor: 6.577