Emotional Distress Predicts Reduced Type 2 Diabetes Treatment Adherence in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE)
Authors' conclusion
Depressive symptoms and diabetes distress both predict lower adherence to glucose-lowering medications over time among adults with T2DM. Addressing emotional distress and concerns about anticipated negative effects of taking these treatments may be important to support diabetes treatment adherence.
Study context
- Population
- Adults with relatively recent-onset T2D in GRADE (4 glucose-lowering medications added to metformin); baseline mean age 58.0 ± 10.2 years, 66% male, diabetes duration 4.2 ± 2.8 years, HbA1c 7.5% ± 0.5%
- Participants
- 1,739 adults
- Primary endpoint
- Medication adherence predicted by baseline depressive symptoms and diabetes distress
- Follow-up
- 36 months
Methodological detailslongitudinal, Emotional Distress Substudy, Self-completed questionnaires administered biannually up to 3 years
- Longitudinal
- Emotional Distress Substudy
- Self-completed questionnaires administered biannually up to 3 years
Primary result
As reported in the abstract
Baseline depressive symptoms and diabetes distress vs medication adherence · over 36 months
- Higher baseline depressive symptoms and diabetes distress independently associated with lower adherence
- P < 0.001
Further findings
Visit-to-visit bidirectional relationships · subsequent 6-month visit
- Higher depressive symptoms and diabetes distress at one visit predicted lower adherence at the next 6-month visit, but not vice versa
- P < 0.0001
- Treatment assignment did not moderate relationships
Mediation of the emotional distress–adherence link
- Patient-reported concerns about diabetes medications mediated the largest percentage
- 11.9%-15.5%
Baseline medication adherence
- Mean ± SD medication adherence
- 89.9% ± 11.1%
Original publication
Emotional Distress Predicts Reduced Type 2 Diabetes Treatment Adherence in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care. Published 16 January 2024. doi:10.
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