[Drug compliance in type 2 diabetes: role of drug treatment regimens and consequences on their benefits].
Compliance is an old issue but crucial in the management of chronic diseases. This is the case in type 2 diabetes mellitus which requires several drugs, either to treat diabetes or to prevent cardiovascular complications. In this review, we discuss the relationships between drug treatment regimens and treatment compliance in type 2 diabetes and other chronic diseases. The greater the number of daily drug intakes, the worst the compliance, even if a single daily intake may cause an increased risk of overdosing. Although the number of tablets or treatments is less frequently linked to compliance level than the number of daily intake, polytherapy is generally associated with a poor compliance. The consequences of a poor compliance on the prognosis or the management of these diseases are analysed based on cardiovascular studies. Even if nearly no studies exist in type 2 diabetes, to improve treatment compliance represents a major challenge in these patients. Such improvement requires to preferentially use once-a-day intake, but this is still difficult with several oral anti-diabetics. Fixed combinations such as the glibenclamide plus metformin combination, cause a decrease in the number of daily tablets and this permit a better compliance. Such approaches, to be fully beneficial, should be part of a global management of these type 2 diabetic patients, taking into account all their difficulties to follow their treatments, and based on a strong physician and patient relationship.
Service de Diabétologie, Hôpital Jean-Minjoz, 25030 Besançon Cedex. alfred.penfornis@ufc.chu.univ-fcomte.fr
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Penfornis
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D005905:Glyburide / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use; D010349:Patient Compliance; D010353:Patient Education as Topic; D011379:Prognosis
D007004:Hypoglycemic Agents; D008687:Metformin; D005905:Glyburide