Treatment Adherence in Patients with Type 2 Diabetes Mellitus: Associations with Clinical and Metabolic Factors

Abstract

Objective: This study aimed to assess treatment adherence according to antidiabetic treatment regimens and its associations with medication burden and clinical outcomes in patients with type 2 diabetes mellitus (T2DM).Methods: This cross-sectional study was conducted between January and April 2024 in the endocrinology department of a tertiary care hospital. Adult patients diagnosed with T2DM for at least one year were included. Sociodemographic data, comorbidities, diabetes-related complications, treatment and lifestyle characteristics, laboratory parameters (HbA1c and C-peptide), and self-reported adherence were recorded. Treatment adherence was assessed using the validated Turkish version of the Treatment Adherence in Type 2 Diabetes Mellitus (TAT2DM) Scale. The study was approved by the XXX Ethics Committee (approval no: 2023/5237).Results: The study included 198 patients with T2DM. Hypertension was the most common comorbidity, and diabetic peripheral neuropathy was the most frequent complication. The mean TAT2DM score was 85.2 ± 9.2. HbA1c levels were positively correlated with the total number of medications, oral antidiabetic drugs (OADs), and insulin products (p < 0.001), while C-peptide levels were negatively correlated with the number of insulin products (p = 0.010). The total TAT2DM score was negatively associated with the number of insulin products (p = 0.008) and adherence was significantly higher among patients who exercised regularly (p = 0.024). Treatment adherence and HbA1c levels differed significantly across antidiabetic regimens, with higher adherence and HbA1c observed in patients receiving combined insulin and OAD therapy (p