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Poor understanding of diabetes medications may worsen glycemic profile in type 2 diabetes

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September 7, 2018

In patients with type 2 diabetes, a lack of knowledge regarding diabetes drugs is associated with higher HbA1c level and worse blood glucose profile, according to findings from a cross-sectional study published in the Journal of Diabetes Investigation.

Ryosuke Sakai, MD, of the department of endocrinology and metabolism at Kyoto Prefectural University of Medicine, Graduate School of Medical Science in Japan, and colleagues wrote in the study background. “Thus, to achieve good blood glucose level, many patients with type 2 diabetes receive medication therapy. Regardless of these various approaches, many of them cannot achieve good blood glucose levels. One of the reasons many of them cannot achieve good blood glucose level is poor medication adherence.”

Researchers analyzed data from 479 outpatients with type 2 diabetes (305 men; mean age, 68 years; mean diabetes duration, 12 years; mean HbA1c, 7.2%) seen at the Kyoto Prefectural University of Medicine, between January 2014 and January 2016.

Participants completed a questionnaire regarding lifestyle factors and use of diabetes medications. Researchers assessed medical records regarding current treatments, including medications for diabetes and total number of oral medications. Participants were considered to have poor understanding of diabetes medications if answers to the question “Do you take diabetes medications?” contradicted the prescriptions on the questionnaire.

Researchers evaluated the correlation between poor understanding of diabetes medications and the rates of microvascular complications, smoking status, alcohol consumption, exercise, nephropathy, neuropathy, oral diabetes medications and insulin, using propensity-score matching analysis to eliminate confounders.

Within the cohort, 425 patients (89%) used diabetes medications, with a mean of 5.4 overall diabetes medications and mean 1.7 oral diabetes medications.

Researchers identified 40 patients (8.4%) as having a poor understanding of diabetes medications.

Patients defined as having a poor understanding of diabetes medications had a higher HbA1c vs. those determined to be knowledgeable about their medications(mean, 7.5% vs. 7.2%; P = .041). Patients with poor understanding also had fewer prescriptions for diabetes medications vs. patients with better understanding of their medications (mean, 1.1 vs. 1.7, respectively; P = .001). Researchers also observed an association between poor understanding of diabetes medications and undesirable glucose levels (OR = 2.13; 95% CI, 1.02-4.23).

Among the 74 propensity-matched patients according to the presence of a poor understanding of diabetes medications (62 men; mean age, 66 years; mean diabetes duration, 15 years), researchers observed a greater association between poor understanding of medication and blood glucose in logistic regression analysis (OR = 5.45; 95% CI, 1.54-25.8).

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“This cross-sectional study demonstrates, for the first time, that poor understanding of anti-diabetic medication is associated with poor blood glucose level in patients with type 2 diabetes,” the researchers wrote. “In clinical practice of diabetes, we should consider the understanding of antidiabetic medications.” – by Jennifer Byrne

Disclosures: Sakai reports no relevant financial disclosures. Please see the study for the other authors’ relevant financial disclosures.