60-LB: Oral Diabetes Medication Adherence in Emerging Adults with Youth-Onset Type 2 Diabetes: TODAY2 iCount Study

Abstract

Background: Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) participants have youth-onset type 2 diabetes (T2D) and often poor glycemic control. The role of medication adherence is unknown. Aims: To assess oral diabetes medication adherence in the TODAY2 cohort; To assess participant factors related to adherence. Methods: Participants provided data at TODAY2 visits and at 3 monthly unannounced phone pill counts. Those taking ≥80% of pills were classified “high adherent,” those taking <80% of pills were defined “low adherent.” If not taking oral medications (meds) they were asked reasons and adjudicated (no need for meds vs. non-adherent). The unadjusted association of each factor with adherence status was assessed by ANOVAs (continuous variables) and Pearson χ-square (categorical variables). Factors with p<0.2 were entered into logistic models for adherence. Results: Of 381 individuals, 224 were either taking oral meds (n=190) or taking none though meds were recommended (n=34) [mean age 25 yrs, 67% female, 18% white, 34% black, 39% Hispanic, 84% <$36K income]. Per pill counts, 66.1% were low adherent (includes 15.2% adjudicated non-adherent). Unadjusted results: HbA1c was lower in high vs. low adherent groups (9.2% vs. 10.0%, p<0.04). Racial/ethnic differences in adherence (55.3% non-Hispanic whites, 60.2% Hispanics, 85.7% non-Hispanic blacks were low adherent, p<0.002). Of those with/without insurance, 65.5%/91.4% were low adherent (p<0.004). After adjustment, race/ethnicity (p<0.02) and insurance status (p<0.007) remained related to adherence. HbA1c, age, gender, education, income, employment, BMI, T2D duration, family history, and no. of complications did not relate to adherence. Conclusion: In emerging adults with youth-onset T2D, poor adherence to oral diabetes meds was common, and significantly more likely in those without health insurance and in non-Hispanic blacks. Interventions are needed to improve adherence and outcomes. Disclosure P.M. Trief: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. S. Kalichman: None. D. Wang: None. K. Drews: None. B. Anderson: None. R.S. Weinstock: Board Member; Self; JDRF. Consultant; Self; Insulogic LLC. Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Jaeb Center for Health Research, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc. Funding National Institutes of Health (R01DK110456)