Early diabetes medication nonadherence has grave outcomes
medwireNews: Patients who are not diligent about taking their antidiabetic medications during the first year after type 2 diabetes diagnosis are at increased risk for cardiovascular events and death over the subsequent years, research shows.
Nonadherent patients had a significant 21% increased risk for death within the first 5 years after diabetes diagnosis, and a 14% and 22% increased risk for myocardial infarction and stroke, respectively, after accounting for variables including health status, report Justin Gatwood (University of Tennessee Health Science Center, Memphis, USA) and study co-authors.
Their research, which appears in Diabetic Medicine, involved 159,032 newly diagnosed patients identified in the Veterans Affairs Corporate Data Warehouse, 63.2% of whom obtained sufficient medication to allow for at least 80% adherence during the first year.
Nonadherent patients had a significantly reduced risk for developing neuropathy and retinopathy, and an increased likelihood for starting insulin, but the researchers attribute this to a “healthy adherer” effect, with greater engagement with healthcare leading to prompt diagnosis of microvascular complications and escalation of therapy.
“[P]roviders should work with patients from the onset of therapy to ensure that barriers to adherence are identified and removed in order to limit the impact of this behaviour on poor future outcomes,” says the research team.
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