Adherence to medication, glycaemic control and hospital attendance in young adults with type 2 diabetes

Abstract

Type 2 diabetes is becoming common among people in their 20s and 30s. Glycaemic control is suboptimal in this group and is associated with poor medication adherence. We studied medication adherence over a 24-month period in all diabetes clinic registrants (n = 266) between the ages of 18 and 39 years. We reviewed their glycaemic control using mean HbA1c over the study period and examined hospital records to determine the number of hospital attendances during this time. We found that less than half the group (47%) had good adherence (>90%) and 21% of the group had very poor adherence (<50%). Mean adherence was slightly poorer in women compared to men (73% vs 76%, P = 0.04). There was a marked inverse relationship between adherence and glycaemic control. Mean HbA1c is 70 mmol/mol among those with good adherence and mean HbA1c is 97 mmol/mol among those with very poor adherence (P < 0.05). Fifty-seven per cent of the study group had at least one hospital attendance during this time. Eighty-eight hospital attendances were due to a medical cause. Study of trend showed more medical admissions among those with very poor adherence (P = 0.03). Mean HbA1c was higher in those who required medical admissions (87 mmol/mol vs 75 mmol/mol) when compared to those with no hospital attendance. Our study shows that poor adherence is common and significantly related to glycaemic control as well as unplanned hospital attendances for medical conditions. Despite limitations, our study provides valuable information on medication adherence and its impact on glycaemic control and morbidity among young people with type 2 diabetes.

Antidepressant dispensing before, during, and after pregnancy in New Zealand, 2005‒2014

“…Further research would be required to establish why younger pregnant women were more likely to stop their antidepressant in early pregnancy. Other New Zealand studies have shown lower adherence to medicine in younger people, 36,37 but it would be useful to see if pregnant women, particularly younger ones, were engaging in psychosocial therapies instead. Determining engagement with non-pharmacological interventions in pregnancy would be informative, as there is a mismatch between those taking an antidepressant in pregnancy (<5%) and the reported prevalence of depressive symptoms (12%).…”

Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study

“… 32 In young adults with type 2 diabetes, it has been shown that adherence to antihyperglycemic agents (as judged by prescriptions lodged with community pharmacies) was closely related to glycemic control and risk of hospitalization. 33 Medication dispensing was suboptimal among young people with type 2 diabetes in this study: only 63% had diabetes medications dispensed and nearly a third (31%) of those with severe hyperglycemia (HbA 1c > 100 mmol/mol (≥11.3%)) had not been dispensed any diabetes medication in a 6-month period.…”

Comorbid Diabetes and Severe Mental Illness: Outcomes in an Integrated Health Care Delivery System

“…1). Specifically, young adults [18][19][20][21][22][23][24][25][26][27][28][29] had over twice the risk of having poor control compared to older adults (aRR 2.15, 95% CI 1.65-2.79, p < 0.001), Hispanics were 18% more likely to have poor control compared to whites (aRR 1.18, 95% CI 1.01-1.39, p value 0.041), and people without any primary care visits were over twice as likely to have poor control when compared to those who frequently utilized primary care services (aRR 2.72, 95% CI 2.23-3.33, p < 0.001).…”

“…In addition, we found disparities in diabetes control among subpopulations with SMI, specifically young adults and Hispanics, which is consistent with prior work in the general population. 27,28 This adds to the growing evidence that young adults and minorities with SMI could benefit from enhanced screening and early identification of diabetes. 2,15,16,23 It is possible that these positive health care outcomes may be a direct result of better adherence to diabetes medications.…”