TY - JOUR T1 - Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death. JF - J Diabetes Complications Y1 - 2015 A1 - Chen, Yiqun A1 - Frank A Sloan A1 - Arseniy P Yashkin KW - Aged KW - Aged, 80 and over KW - Combined Modality Therapy KW - Diabetes Complications KW - Diabetes Mellitus KW - Early Diagnosis KW - Female KW - Health Promotion KW - Health Surveys KW - Humans KW - Hypoglycemic Agents KW - Longitudinal Studies KW - Male KW - Mass Screening KW - Medicare Part A KW - Medicare Part B KW - Medication Adherence KW - Motor Activity KW - Patient Compliance KW - Practice Guidelines as Topic KW - Risk KW - United States AB -

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.

PB - 29 VL - 29 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26316423?dopt=Abstract U2 - PMC4656150 U4 - Diabetes complications/Mortality/health status/adherence interventions/adherence interventions/Physical activity/Guidelines ER -