Medication Intake, Perceived Barriers, and Their Correlates Among Adults With Type 1 and Type 2 Diabetes: Results From Diabetes MILES - The Netherlands.

Stijn Hogervorst,Jane Speight,Mariska Bot,Frans Pouwer,Giesje Nefs,Jacqueline G Hugtenburg,Marce C Adriaanse

doi:10.3389/fcdhc.2021.645609

Abstract

The purpose of this study is to investigate medication intake, perceived barriers and their correlates in adults with type 1 or type 2 diabetes. In this cross-sectional study, 3,383 Dutch adults with diabetes (42% type 1; 58% type 2) completed the 12-item 'Adherence Starts with Knowledge' questionnaire (ASK-12; total score range: 12-60) and reported socio-demographics, clinical and psychological characteristics and health behaviors. Univariable and multivariable logistic regression analyses were used. Adults with type 1 diabetes had a slightly lower mean ASK-12 score (i.e. more optimal medication intake and fewer perceived barriers) than adults with non-insulin-treated type 2 diabetes. After adjustment for covariates, correlates with suboptimal intake and barriers were fewer severe hypoglycemic events and more depressive symptoms and diabetes-specific distress. In type 2 diabetes, correlates were longer diabetes duration, more depressive symptoms and diabetes-specific distress. Adults with type 1 diabetes showed slightly more optimal medication intake and fewer perceived barriers than adults with non-insulin treated type 2 diabetes. Correlates differed only slightly between diabetes types. The strong association with depressive symptoms and diabetes-specific distress in both diabetes types warrants attention, as improving these outcomes in some people with diabetes might indirectly improve medication intake.

Highlights

The global prevalence of both type 1 and type 2 diabetes is at an all-time high while incidence and prevalence rates continue to increase [1, 2]
The total sample consisted of 3,383 adults with diabetes, of whom 42% (n=1,422) had type 1 diabetes and 58% (n=1,961) had type 2 diabetes
The present study showed that adults with type 1 diabetes had slightly more optimal medication intake and fewer perceived barriers than adults with noninsulin-treated type 2 diabetes

Summary

Introduction

The global prevalence of both type 1 and type 2 diabetes is at an all-time high while incidence and prevalence rates continue to increase [1, 2]. The cornerstone of optimal glycemic outcomes in both type 1 and type 2 diabetes relies on diligent self-management, of which medication intake is a central element [7, 8]. Only 50% of adults with type 2 diabetes have an A1C of

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