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Type 2 Diabetes: Young Patients Lax with Medicating Show Signs of Depression

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Type 2 Diabetes: Young Patients Lax with Medicating Show Signs of Depression
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In a recent study published in the journal Diabetes Care, a team of researchers found that Type 2 diabetes medication adherence is not affected by age, sex, parental education, family income, or treatment group. However, low compliance with prescribed medication treatment was found among youths with Type 2 diabetes with depressive symptoms.

The study, “Correlates of Medication Adherence in the TODAY Cohort of Youth With Type 2 Diabetes,” was led by Kathryn Hirst at George Washington University Biostatistics Center in Rockville, Maryland,

According to a recent news release, the team evaluated data from 699 children, 10 to 17 years old, with recent-onset Type 2 diabetes, from the TODAY trial (Treatment Options for Type 2 Diabetes in Adolescents and Youth). The study was geared to identify factors that predict compliance with a medication regimen, and to investigate potential associations among medication adherence, glycemic control, and indices of insulin action.

Children were assigned to one of three treatment groups: metformin alone, metformin in combination with rosiglitazone, or metformin in combination with an intensive lifestyle program.

All participants were given two pills per day; medication adherence was measured by pill count when packs were returned at clinic visits. High medication adherence was defined as taking at least 80 percent of medication, and low adherence as taking less than 80 percent.

The results showed that there were no differences between high and low adherence based on the patient’ sex, age, family income, parental education, or treatment group. However, medication adherence was found to decline over time (72 percent adherence at 2 months, and 56 percent adherence at 48 months).

Researchers also found that at study entry, a greater percentage of the participants with low medication adherence had symptoms of clinical depression and that those patients were more likely to not follow medication guidelines throughout the study.

The results also showed that participants with high adherence, had significantly greater insulin sensitivity and oral disposition index compared with those with low adherence.

According to the study: “The only participant characteristic that was related to low medication adherence was the presence of baseline clinically significant depressive symptoms. We found that no cutoff medication adherence in the TODAY trial was related to time to treatment failure. Although medication adherence was associated with better insulin sensitivity, it could not compensate for the progressive decline in beta-cell function.”

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