Correlates of Medication Adherence in the TODAY Cohort of Youth With Type 2 Diabetes
| Autor: | Lorraine E. Levitt Katz, A. Wauters, Terri L Casey, Siripoom McKay, Barbara J. Anderson, Laurie A. Higgins, Roberto Izquierdo, Kathryn Hirst, Kristen J. Nadeau |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes Sensitivity and Specificity law.invention Body Mass Index Medication Adherence Cohort Studies 03 medical and health sciences 0302 clinical medicine Insulin resistance Randomized controlled trial law 030225 pediatrics Internal medicine Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents Insulin Child Glycemic Advanced and Specialized Nursing Glycated Hemoglobin business.industry Depression Clinical Care/Education/Nutrition/Psychosocial Research medicine.disease Metformin Diabetes Mellitus Type 2 Socioeconomic Factors Cohort Physical therapy Female Insulin Resistance business Body mass index Cohort study |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE To identify factors that predict medication adherence and to examine relationships among adherence, glycemic control, and indices of insulin action in TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth). RESEARCH DESIGN AND METHODS A total of 699 youth 10–17 years old with recent-onset type 2 diabetes and ≥80% adherence to metformin therapy for ≥8 weeks during a run-in period were randomized to receive one of three treatments. Participants took two study pills twice daily. Adherence was calculated by pill count from blister packs returned at visits. High adherence was defined as taking ≥80% of medication; low adherence was defined as taking RESULTS In this low socioeconomic cohort, high and low adherence did not differ by sex, age, family income, parental education, or treatment group. Adherence declined over time (72% high adherence at 2 months, 56% adherence at 48 months, P < 0.0001). A greater percentage of participants with low adherence had clinically significant depressive symptoms at baseline (18% vs. 12%, P = 0.0415). No adherence threshold predicted the loss of glycemic control. Longitudinally, participants with high adherence had significantly greater insulin sensitivity and oDI than those with low adherence. CONCLUSIONS In the cohort, the presence of baseline clinically significant depressive symptoms was associated with subsequent lower adherence. Medication adherence was positively associated with insulin sensitivity and oDI, but, because of disease progression, adherence did not predict long-term treatment success. |
| Databáze: | OpenAIRE |
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