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

Abstract

Aims: This study aimed to analyse the association between adherence to treatment and glycaemic control in people with type 2 diabetes mellitus.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Adherence treatment; Diabetes mellitus; Lifestyle; Nutrition and diet; Primary care.