Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.

TitleAdherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.
Publication TypeJournal Article
Year of Publication2015
AuthorsChen, Y, Sloan, FA, Yashkin, AP
JournalJ Diabetes Complications
Date Published2015 Nov-Dec
ISSN Number1873-460X
KeywordsAged, Aged, 80 and over, Combined Modality Therapy, Diabetes Complications, Diabetes Mellitus, Early Diagnosis, Female, Health Promotion, Health Surveys, Humans, Hypoglycemic Agents, Longitudinal Studies, Male, Mass Screening, Medicare Part A, Medicare Part B, Medication Adherence, Motor Activity, Patient Compliance, Practice Guidelines as Topic, Risk, United States

AIMS: Analyze relationships between adherence to guidelines for diabetes care - regular screening; physical activity; and medication - and diabetes complications and mortality.

METHODS: Outcomes were onset of congestive heart failure (CHF), stroke, renal failure, moderate complications of lower extremities, lower-limb amputation, proliferative diabetic retinopathy (PDR), and mortality during follow-up. Participants were persons aged 65+ in the Health and Retirement Study (HRS) 2003 Diabetes Study and had Medicare claims in follow-up period (2004-8).

RESULTS: Adherence to screening recommendations decreased risks of developing CHF (odds ratio (OR)=0.83; 95% confidence interval (CI): 0.72-0.96), stroke (OR=0.80; 95% CI: 0.68-0.94); renal failure (OR=0. 82; 95% CI: 0.71-0.95); and death (OR=0.86; 95% CI: 0.74-0.99). Adherence to physical activity recommendation reduced risks of stroke (OR=0.64; 95% CI: 0.45-0.90), renal failure (OR=0.71; 95% CI: 0.52-0.97), moderate lower-extremity complications (OR=0.71; 95% CI: 0.51-0.99), having a lower limb amputation (OR=0.31, 95% CI: 0.11-0.85), and death (OR=0.56, 95% CI: 0.41-0.77). Medication adherence was associated with lower risks of PDR (OR=0.35, 95% CI: 0.13-0.93).

CONCLUSIONS: Adherence to screening, physical activity and medication guidelines was associated with lower risks of diabetes complications and death. Relative importance of adherence differed among outcome measures.

User Guide Notes

Endnote Keywords

Diabetes complications/Mortality/health status/adherence interventions/adherence interventions/Physical activity/Guidelines

Endnote ID


Alternate JournalJ Diabetes Complications
Citation Key8268
PubMed ID26316423
PubMed Central IDPMC4656150
Grant ListR01 AG017473 / AG / NIA NIH HHS / United States
R01-AG017473 / AG / NIA NIH HHS / United States