Adherence to recommendations and effectiveness of glucose-lowering treatment in type 2 diabetes patients receiving insulin based in the Nizhny Novgorod region on data of mobile diagnostic and therapeutic centre "Diabetes mellitus"

Adherence to treatment is an important factor in diabetes management. Poor adherence may cause ineffective control, especially in insulin-treated patients. Aim of the study: to evaluate the adherence to nutrition, physical activity and self-monitoring in T2DM patients who do and do not receive insulin treatment. Materials and methods. 550 T2DM patients were examined as a part of mobile diabetes center in different areas of the Nizhny Novgorod region. Clinical examination results, HbA1c, creatinine and microalbuminuria were assessed. Adherence to treatment was evaluated by questionnaire Diabetes Self-Care Activities. Results. Insulin-treated patients had longer diabetes duration and worse HbA1 с level and similar levels of adherence related to diet, physical activity, foot care. Only for glucose self-monitoring was adherence higher. Best HbA1c values were observed in patients with adherence in middle region of 3-5 days. Conclusion. Long diabetes duration and worse glycemic control in insulin-treated T2DM patients is not associated with better adherence to treatment. This may be viewed as evidence on insufficient patients education and can be a potential target for improvement of glycemic control.