Impact of adherence to Mediterranean diet and/or drug treatment on glycaemic control in type 2 diabetes mellitus patients: DM2-CUMCYL study

• Published in: Primary care diabetes Vol. 14; no. 6; pp. 685 - 691
• Main Authors: Sánchez-Hernández, María Sonsoles, Rodríguez-Caldero, María Cristina, Martín-Pérez, María Pilar, Mira-Solves, Jose Joaquín, Vitaller-Burillo, Julian, Carratalá-Munuera, María Concepción
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2020
• Subjects: Adherence treatment; Diabetes mellitus; Lifestyle; Nutrition and diet; Primary care; Adherence treatment; Lifestyle; Primary care; Diabetes mellitus; Nutrition and diet
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2020.06.008

•A third of type 2 diabetes patients had poor glycaemic control (HbA1c ≤58 mmol/mol).•Age, smoking, rural residence, time since diagnosis and polypharmacy increased risk.•The Morisky-Green Medication Adherence Scale showed a non-adherence of 34%.•Non-adherence was associated with low education and sedentarism. This study aimed to analyse the association between adherence to treatment and glycaemic control in people with type 2 diabetes mellitus. Multicentre, cross-sectional study in patients with type 2 diabetes mellitus recruited by primary care professionals in Castilla y León (Spain). Sociodemographic and clinical characteristics were reflected in self-reported questionnaire, which included the Morisky-Green Medication Adherence Scale and the 14-point Mediterranean Diet Adherence Screener. Medication non-adherence and poor glycaemic control were analysed by bivariable and multivariable analyses. Of 3536 included patients, the 33.8% reported non-adherence to pharmacological treatment, and the 33.7% had poor glycaemic control (HbA1c ≥58 mmol/mol [7.5%]); 50.6% of patients reported moderate-high adherence to the Mediterranean diet (≥9 points). The multivariable logistic regression model showed that educational level (OR 0.73; 95% CI 0.61-0.87; p < 0.001) and sedentarism (OR 1.64; 95% CI 1.36−1.98; p < 0.001) were associate with low adherence. Younger age, rural residence, smoking, time since diagnosis (OR 1.04; 95% CI 1.03−1.05; p < 0.001) and polypharmacy were associated with poor glycaemic control. Lower educational level and sedentarism were associated with low adherence. Younger age, rural residence, smoking, time since diagnosis and polypharmacy, increased risk of poor glycaemic control.