Adherence to medical recommendations (compliance) in diabetic patients treated in outpatient care

Introduction. Proper treatment aimed at reducing long- -term complications of diabetes requires a multifactorial therapy, which often is associated with polypragmasia. The purpose of this study was to assess compliance in patients with diabetes, depending on the type of treatment and the number of oral drugs prescribed. Material and methods. 263 patients including 67 with type 1 diabetes, mean age 59 ± 16 years, duration 12 ± 9 years, BMI 29 ± 6 kg/m2. Subjects studied out during a visit to the Diabetes Clinic completed the questionnaire, which contains general information about treatment method and the number of active drugs. Furthermore, patients completed the questionnaire by Morisky and Green (MG) assessing compliance. Results. Compliance in patients with type 1 was signifi cantly higher when compared to type 2 (respectively 0.6 ± 0.9 pts vs 0.9 ± 0.9 pts at MG scale, p = 0.019), also higher percentage of type 1 patients declared a high level of compliance (61% vs 28%, p < 0.001). Type 1 patients with high compliance had signifi cantly longer duration time of diabetes than patients with medium and low (21 ± 11.3 y vs 14 ± 9.9 y, p = 0.012), among patients with type 2 diabetes similar relation was not observed. Compliance in patients with type 2 was signifi cantly higher among those treated with insulin (0.7 ± 0.8 pts at MG scale) compared to those treated with OHA (1.1 ± 1 pts at MG scale, p = 0.006), moreover higher percentage of patients on insulin therapy declared high level of compliance (50% vs 29%, p = 0.002). Average PPG in the group with high compliance is signifi cantly higher in type 1 patients in relation to type 2 patients (177 ± 33 mg/dl vs 143 ± 43 mg/dl, p < 0.001). There was no correlation between compliance and the number of taken tablets. Conclusions. Patients treated with insulin show a signifi cantly higher degree of compliance. This is probably due to the high level of education of patients on insulin therapy. The lower level of compliance in the treatment of OHA indicates the need for increased efforts educate patients on oral agents.