Medication Adherence in Diabetes

Medication Adherence in Diabetes

What Is Medication Adherence?

Medication adherence is a term that describes whether a patient adheres to, or follows, their medication plan.1 It usually refers more specifically to whether medications are taken as prescribed (eg, twice a day during meals) and taken for the prescribed period of time without skipping or stopping.


Why Is Medication Adherence Important? 

The topic of medication adherence is important for individuals with diabetes.2 An abundance of evidence suggests that achieving glycemic control is the most important predictor of reducing diabetes-related complications and its associated illnesses and death. Studies have demonstrated that receiving intensive glucose therapy with prescribed medications (eg, sulfonylurea, insulin, or metformin) can significantly reduce microvascular complications when compared to conventional therapy using dietary interventions alone.3 However, these significant improvements in glycemic control attributed to pharmacotherapy can only be achieved when plans for medications are adhered to. Research has shown that non-adherence with blood glucose lowering medications is associated with greater hemoglobin (Hb) A1c values, and that each 10% increase in medication adherence is associated with a significant 0.14-0.16% decrease in HbA1c values.2 Given that even modest improvements in HbA1c values result in clinically significant benefits, increasing medication adherence among patients with diabetes on pharmacotherapy is of great interest.4–6


What Affects Medication Adherence?

Currently reported incidence of nonadherence to medications among individuals with type 2 diabetes mellitus range from 36% to 93% depending on study methodology, with certain studies reporting adherence as low as 36.7%.2,7

Various factors play a role in medication adherence, including both non-modifiable and modifiable factors.7 Certain demographic factors such as younger age, lower income, and lower education level are known to be associated with lower medication adherence in individuals with type 2 diabetes. However, identifying key modifiable factors can be helpful in addressing the issue of nonadherence. Researchers believe that a patient’s perception of treatment efficacy, fear of a hypoglycemic event, treatment complexity, out-of-pocket cost, beliefs surrounding medication, and trust in physicians also play important roles in medication adherence. 

One of the key ways to improve medication adherence is through improved communication with health care professionals. Doctors should clearly lay out the risks and benefits of each medication, address any concerns or questions, make medication-related decisions together, and provide support for self-management. If you are struggling to keep track and regularly take all of medications, it may be helpful to follow a few simple tips on managing multiple medications. Be sure to communicate any concerns or barriers regarding taking medications and ask your provider any questions you may have about your medications.


1. Ho PM, Bryson CL, Rumsfeld JS. Medication Adherence. Circulation. 2009;119(23):3028-3035. doi:10.1161/CIRCULATIONAHA.108.768986
2. Wabe NT, Angamo MT, Hussein S. Medication Adherence in Diabetes Mellitus and Self Management Practices Among Type-2 Diabetics in Ethiopia. N Am J Med Sci. 2011;3(9):418-423. doi:10.4297/najms.2011.3418
3. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HAW. 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes. N Engl J Med. 2008;359(15):1577-1589. doi:10.1056/NEJMoa0806470
4. UK Prospective Diabetes Study (UKPDS) Group. Intensive Blood-Glucose Control With Sulphonylureas or Insulin Compared With Conventional Treatment and Risk of Complications in Patients With Type 2 Diabetes (UKPDS 33). Lancet. 1998;352(9131):837-853.
5. ADVANCE Collaborative Group, Patel A, MacMahon S, et al. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2008;358(24):2560-2572. doi:10.1056/NEJMoa0802987
6. US Food and Drug Administration. Guidance for Industry: Diabetes Mellitus: Developing Drugs and Therapeutic Biologics for Treatment and Prevention. Released February 13, 2008. Accessed February 21, 2023.
7. Polonsky WH, Henry RR. Poor Medication Adherence in Type 2 Diabetes: Recognizing the Scope of the Problem and Its Key Contributors. Patient Prefer Adherence. 2016;10:1299-1307. doi:10.2147/PPA.S106821



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