Medication and diet adherence in patients with type 2 diabetes and depressive disorder: a scoping review

Abstract

Background: Diet adherence (DA) is one of the most critical factors that determine the effectiveness of therapy among patients with type 2 diabetes mellitus (T2DM). Concomitant depressive disorder (DD) may affect treatment adherence. Aim of the study: This review aimed to synthesize the results of research published between 2010–2020 on medication adherence and DA among patients with co-occurring T2DM and DD. Potential factors related to DA are also discussed. Material and methods: This scoping review was conducted on studies published between January 2010 to November 2020. The literature review was carried out using the PubMed (MEDLINE®) medical database. The following inclusion criteria were applied: (1) written in English, (2) published in the last ten years (between 2010 and 2020), (3) applied to patients with diagnosed T2DM and DD, (4) analyzed DA, and (5) original or review studies. Results: Twenty-six studies were included in the final review. Three main areas were analyzed in the context of DD and effectiveness of T2DM therapy: (1) general medication adherence, (2) glycemic control, and (3) DA. Only 16 of the 26 included studies examined the effects of DD on DA, and 14 of those 16 studies reported a negative impact of DD symptoms on DA. Conclusions: A higher intensity of DD symptoms was associated with poorer medication adherence and DA. These data suggest that it is critical to develop proper therapeutic interventions that can strengthen personality dispositions (e.g., self-efficacy) and/or improve social support.