Patient-reported tolerability issues with oral antidiabetic agents: Associations with adherence; treatment satisfaction and health-related quality of life

Diabetes Res Clin Pract. 2010 Feb;87(2):204-10. doi: 10.1016/j.diabres.2009.11.023. Epub 2009 Dec 29.


Aims: The study's aim was to quantify prevalence of tolerability issues among patients with T2DM currently treated with OADs and to assess its association with treatment adherence, satisfaction and health-related quality of life (HRQL).

Methods: Data were collected from the 2006-2008 US National Health and Wellness Survey and the Ailment Panel of Lightspeed Online Research, an internet-based questionnaire. Participants (N=2074) self-reported a diagnosis of T2DM, were >18 years of age and currently taking >1 OADs but not insulin, and spoke English.

Results: The majority (71.7%) experienced at least 1 tolerability issue in the past 2 weeks; 49.7% experienced >2. Tolerability issues included signs/symptoms of hypoglycemia (57.2%), constipation/diarrhea (28%), headaches (25.6%), weight gain (22.9%) and water retention (21.0%). There was a significant association between the number of tolerability issues and both the likelihood of non-adherence (r=0.20, p<0.01) and reduced treatment satisfaction (r=-0.42, p<0.01). Each additional tolerability issue was associated with 28% greater likelihood of medication non-adherence. Constipation/diarrhea (b=-0.02, p<0.01) and symptoms of hypoglycemia (b=-0.08, p<0.01) were significantly associated with lower HRQL scores.

Conclusions: Optimizing OAD therapy of T2DM by improving tolerability may increase patient satisfaction, medication adherence and HRQL, and may increase the likelihood of attaining treatment goals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Constipation / chemically induced
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / psychology
  • Diarrhea / chemically induced
  • Drug Tolerance / physiology*
  • Female
  • Headache / chemically induced
  • Health Status
  • Health Surveys
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Internet
  • Male
  • Medication Adherence
  • Middle Aged
  • Personal Satisfaction
  • Quality of Life
  • Surveys and Questionnaires
  • United States
  • Weight Gain / drug effects


  • Hypoglycemic Agents