Vol 2, No 5 (2013)
Research paper
Published online: 2013-10-25

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The impact of adherence to medical recommendations (compliance) on incidence of hypoglycemia in diabetic patients treated in outpatient clinic

Maciej Molsa, Marek Tłuczykont, Anna Markowicz, Krzysztof Strojek
Diabetologia Kliniczna 2013;2(5):165-171.

Abstract

Introduction. Both form of therapy and compliance may influence on the incidence of hypoglycemia, which is dangerous for patient’s health status and even life. The aim of the study was evaluation of the number and frequency of hypoglycemia in relation to the level of compliance among diabetic patients treated in outpatient clinic.

Material and methods. 263 patients including 67 with type 1 (age 59 ± 16 years, duration 12 ± 9 years, BMI 29 ± 6 kg/m2). Study participants completed the questionnaire containing general data, Morrisky Green scale presence of hypoglycemia.

Results. During the last year 860 hypoglycemia episodes occurred among 107 (41%) patients. High compliance to hypoglycemia (51% of patients with high vs. 35% medium + low compliance, p < 0.05). It was present predominantly to mild hypoglycemia (48% vs. 33%, p < 0.05). We noticed higher frequency of severe hypoglycemia (among those who experienced episodes) in the group with type 1 diabetes and high compliance in comparison with medium and low (2.83 ± 1.73 vs. 1 ± 0 incidents/year, p < 0.05). Among patients with type 2 diabetes we observed higher number of those experiencing hypoglycemia in the group with high compliance when compared tomedium + low (48% vs. 28%, p < 0.05). Analysis of mild hypoglycemia confi rmed these trends (44% vs. 26%, p < 0.05).

Conclusions. Patients with high compliance are significantly more exposed hypoglycemia. Patients with type 2 diabetes on insulin with high compliance are particularly more exposed on hypoglycemia. This indicates on the necessity of both treatment algorithms modification and additional education.