title: Patient-reported adherence to insulin regimen is associated with glycemic control among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 3).
abstract: OBJECTIVE
  We investigated the association between self-reported adherence to an insulin regimen and glycemic control in Japanese patients with type 2 diabetes.
  
  
  METHODS
  Data from 1441 patients with type 2 diabetes who were treated with insulin were obtained from a diabetes registry in Japan. We obtained information on self-reported adherence to an insulin regimen. Relative risk regression analysis was employed to assess the independent association of various demographic factors with good glycemic control (HbA1c<7.0% [53 mmol/mol]) while adjusting for possible confounders.
  
  
  RESULTS
  The mean age, body mass index, and number of daily insulin injections of participants were 65.4 years, 24.7 kg/m(2), and 2.3, respectively. Of all patients, 70.6% reported high adherence to their insulin regimen. Compared with participants with higher adherence, the crude relative risk of good glycemic control was 0.82 (95% CI, 0.67-1.00) for those with middle adherence and 0.64 (95% CI, 0.31-1.31) for those with lower adherence (P=0.029 for trend). Subgroup analysis confirmed this association in patients below 65 years old, but not in those 65 years old and over.
  
  
  CONCLUSIONS
  A higher adherence to a daily insulin regimen was associated with a greater likelihood of good glycemic control in Japanese type 2 diabetes patients. This association was not seen in patients of 65 years old or over. Self-reported adherence to an insulin regimen may prove useful in titrating insulin dose in patients in the younger age group, but requires further investigation.
authors.affiliation: Department of Endocrinology, Tenri Hospital, Tenri, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Mashitani
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.forename: Shintarou
authors.initials: S
authors.lastname: Okamura
authors.forename: Masako
authors.initials: M
authors.lastname: Kitatani
authors.forename: Miyuki
authors.initials: M
authors.lastname: Furuya
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsunaga
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kuwata
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsujii
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishii
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin