Smoking, unhealthy eating behaviours predict poor adherence to glucose-lowering meds

Medication adherence among patients with diabetes may be negatively influenced by unhealthy lifestyle behaviours such as smoking, skipping breakfast, and eating late in the night, a study suggests.

To examine the clinical variables associated with adherence to oral hypoglycaemic drugs, researchers looked at 8,805 patients (mean age, 53 years; 84 percent male) with diabetes whose medication records were available for at least 1 year. Medication adherence was evaluated by the proportion of days covered (PDC), with PDC of <80 percent defined as nonadherence.

The mean PDC was 80.1 percent, and 32.8 percent of patients were nonadherent. PDC was higher in older patients and lower in smokers. Those with higher PDC tended to have lower levels of HbA1c, low-density lipoprotein cholesterol, and triglycerides.

The PDC for specific oral glucose-lowering drugs was as follows: 82 percent for sulfonylureas, 82 percent for biguanides, 79 percent for thiazolidines, 79 percent for alpha-glucosidase inhibitors, 73 percent for glinides, and 85 percent for DPP-4 inhibitors. The respective rates of nonadherence were 27 percent, 29 percent, 33 percent, 34 percent, 42 percent, and 23 percent.

Logistic analysis found that adherence was associated with older age and taking concomitant medications, whereas nonadherence was linked to skipping breakfast (odds ratio [OR], 0.66, 95 percent confidence interval [CI], 0.57–0.76), late-night eating (OR, 0.86, 95 percent CI, 0.75–0.98), and current smoking (OR, 0.89, 95 percent CI, 0.80–0.99).

In light of the findings, clinicians managing diabetic patients are urged to pay attention to the outlined health-related behaviours to achieve good medication adherence.