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Adherence to Medication, Diet and Physical Activity and the Associated Factors Amongst Patients with Type 2 Diabetes
Open accessAbstract
INTRODUCTION: The prevalence of type 2 diabetes mellitus (T2D) has increased considerably while the outcome of diabetic management is suboptimal. In order to promote diabetic management, associated factors for adherence to medications, diet, and physical activity (PA) need to be more clearly identified amongst patients with T2D. METHODS: This cross-sectional study was conducted on 206 men and 294 women amongst patients with diabetes who were registered in ten special diabetic clinics in Shiraz, Iran from November 2018 to April 2019. Levels of adherence to medication, Mediterranean diet (MD), and physical activity were measured with validated and appropriate questionnaires. RESULTS: Mean age (± SD) was 56.92 ± 0.52 years and 294 (58.8%) were female. Data showed that reduced adherence to medication, MD, and PA increased glycated hemoblobin (HbA1c). Adherence to medication among low, moderate, and high levels was 27.2%, 59.2%, and 13.6%, respectively. Associated factors such as 50-64 years of age, at least 65 years of age, overweight, obese, divorced widow, smoker, and ex-smoker had a significant influence on adherence to medication, P = 0.017, P = 0.018, P = 0.008. P = 0.045, P = 0.026, P < 0.004, and P = 0.001, respectively. In addition, adherence to MD among low, moderate, and high levels was 5.4%, 77.2%, and 17.4%, respectively. Associated factors such as 50-64 years of age, at least 65 years of age, overweight, obese, and smoker had a significant influence on adherence to MD, P = 0.011, P = 0.046, P = 0.002, P < 0.001, and P = 0.032, respectively. Furthermore, adherence to PA among low, moderate, and high levels was 21%, 68.6%, and 10.4%, respectively. Only the non-smoker factor played a significant role in PA adherence, P = 0.010. CONCLUSION: Levels of adherence to medications, diet, and PA amongst patients with T2D are not within the acceptable range. Recognized associated factors that contribute to adherence might improve diabetes management and allow one to tailor the appropriate message to improve glycemic indices.
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“Mean HbA1c was 8.57 (±standard deviation, SD 1.94), 7.63 (±1.32), and 6.47 (±0.7) % in patients with low, moderate, and high adherence to MD, respectively [56].”
From Mediterranean Diet and Obesity-related Disorders: What is the Evidence? (2022) · cites this paper as [56]
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Citations
Cites
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,417
Statistical Power Analysis for the Behavioral Sciences
Cohen, J. (2013) · doi:10.4324/9780203771587 · Cited by 25,373
IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045
Cho, N. H., Shaw, J. E., Karuranga, S., Huang, Y., da Rocha Fernandes, J. D., Ohlrogge, A. W., & Malanda, B. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.02.023 · Cited by 7,283
2011 Compendium of Physical Activities: A Second Update of Codes and MET Values
AINSWORTH, B. E., HASKELL, W. L., HERRMANN, S. D., MECKES, N., BASSETT, D. R., TUDOR-LOCKE, C., GREER, J. L., VEZINA, J., WHITT-GLOVER, M. C., & LEON, A. S. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31821ece12 · Cited by 6,317
Global aetiology and epidemiology of type 2 diabetes mellitus and its complications
Zheng, Y., Ley, S. H., & Hu, F. B. (2018) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.151 · Cited by 5,697
Design and Analysis of Experiments
Dean, A., Voss, D. T., & Draguljić, D. (2017) · Springer texts in statistics · doi:10.1007/978-3-319-52250-0 · Cited by 2,938
Sjöström, M., Ainsworth, B., Bauman, A. E., Bull, F., Hamilton-Craig, C., & Sallis, J. F. (2005) · Cited by 1,403
Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Bommer, C., Sagalova, V., Heesemann, E., Manne‐Goehler, J., Atun, R. A., Bärnighausen, T., Davies, J. I., & Vollmer, S. (2018) · Diabetes Care · doi:10.2337/dc17-1962 · Cited by 1,137
Polonsky, W., & Henry, R. (2016) · Patient Preference and Adherence · doi:10.2147/ppa.s106821 · Cited by 784
Exploring the association between childhood and adolescent obesity and depression: A meta-analysis
Quek, Y., Tam, W. W. S., Zhang, M. W. B., & Ho, R. C. M. (2017) · Obesity Reviews · doi:10.1111/obr.12535 · Cited by 503
Esposito, K., Maiorino, M. I., Ciotola, M., Palo, C. D., Scognamiglio, P., Gicchino, M., Petrizzo, M., Saccomanno, F., Beneduce, F., Ceriello, A., et al. (2010) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0b013e3181e5a159 · Cited by 465
Moghaddam, M., Aghdam, F. B., Jafarabadi, M. A., Allahverdipour, H., Nikookheslat, S., & Safarpour, S. (2012) · doi:10.5829/idosi.wasj.2012.18.08.754 · Cited by 455
Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis
Schwingshackl, L., Missbach, B., König, J., & Hoffmann, G. (2015) · Public Health Nutrition · doi:10.1017/s1368980014001542 · Cited by 340
Physical Activity and Diabetes
Sigal, R. J., Armstrong, M. J., Bacon, S., Boulé, N. G., Dasgupta, K., Kenny, G. P., & Riddell, M. C. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.008 · Cited by 287
Physical Activity and Diabetes
Sigal, R. J., Armstrong, M. J., Colby, P., Kenny, G. P., Plotnikoff, R. C., Reichert, S. M., & Riddell, M. C. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.01.018 · Cited by 256
Bullard, T., Ji, M., An, R., Trinh, L., Mackenzie, M., & Mullen, S. P. (2019) · BMC Public Health · doi:10.1186/s12889-019-6877-z · Cited by 255
Medication Adherence in Type 2 Diabetes: The ENTRED Study 2007, a French Population-Based Study
Tiv, M., Viel, J.-F., Mauny, F., Eschwège, E., Weill, A., Fournier, C., Fagot-Campagna, A., & Penfornis, A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0032412 · Cited by 245
Paraidathathu, T., Azuana, Islahudin, F. H., & Ahmad (2013) · Patient Preference and Adherence · doi:10.2147/ppa.s44698 · Cited by 195
Moderate‐to‐Vigorous Physical Activity and All‐Cause Mortality: Do Bouts Matter?
Saint‐Maurice, P. F., Troiano, R. P., Matthews, C. E., & Kraus, W. E. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.117.007678 · Cited by 175
Adherence to Treatment: The Key for Avoiding Long-Term Complications of Diabetes
Lerman, I. G. (2005) · Archives of Medical Research · doi:10.1016/j.arcmed.2004.12.001 · Cited by 168
Parajuli, J., Saleh, F., Thapa, N., & Ali, L. (2014) · BMC Research Notes · doi:10.1186/1756-0500-7-758 · Cited by 147
Bergman, P., Grjibovski, A. M., Hagströmer, M., Bauman, A. E., & Sjöstróm, M. (2008) · BMC Public Health · doi:10.1186/1471-2458-8-367 · Cited by 134
Aune, D., Schlesinger, S., Norat, T., & Ríboli, E. (2018) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2018.02.011 · Cited by 111
Elsous, A., Radwan, M., Al-Sharif, H., & Mustafa, A. A. (2017) · Frontiers in Endocrinology · doi:10.3389/fendo.2017.00100 · Cited by 109
Waari, G., Mutai, J. K., & Gikunju, J. K. (2018) · Pan African Medical Journal · doi:10.11604/pamj.2018.29.82.12639 · Cited by 104
Adherence to a Mediterranean diet and glycaemic control in type 2 diabetes mellitus
Esposito, K., Maiorino, M. I., Di Palo, C., Giugliano, D., & for the Campanian Postprandial Hyperglycemia Study Group (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02798.x · Cited by 102
Improving Patients' Adherence to Physical Activity in Diabetes Mellitus: A Review
Qiu, S.-H., Sun, Z.-L., Cai, X., Liu, L., & Yang, B. (2012) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2012.36.1.1 · Cited by 78
The association of smoking with medical treatment adherence in the workforce of a large employer
Sherman, B. W., & Lynch, W. (2014) · Patient Preference and Adherence · doi:10.2147/ppa.s60927 · Cited by 65
Chew, B., Hassan, N. H., & Sidik, S. M. (2015) · Patient Preference and Adherence · doi:10.2147/ppa.s81612 · Cited by 64
Adherence to physical activity in adults with chronic diseases: ELSA-Brasil
Forechi, L., Mill, J. G., Griep, R. H., Santos, I. S., Pitanga, F. J. G., & Molina, M. D. C. B. (2018) · Revista de Saúde Pública · doi:10.11606/s1518-8787.2018052000215 · Cited by 61
Physical Activity and Diabetes
Salvatoni, A., Cardani, R., Biasoli, R., Salmaso, M., Paoli, A. D., & Nespoli, L. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.02.009 · Cited by 60
The association between the measurement of adherence to anti-diabetes medicine and the HbA1c
Doggrell, S. A., & Warot, S. (2014) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-014-9929-6 · Cited by 59
Adherence to the Mediterranean dietary pattern and BMI change among US adolescents
Martín‐Calvo, N., Chavarro, J. E., Falbe, J., Hu, F. B., & Field, A. E. (2016) · International Journal of Obesity · doi:10.1038/ijo.2016.59 · Cited by 51
Sahebkar, M., Miri, H. H., Noormohammadpour, P., Akrami, R., Mansournia, N., Tavana, B., Mansournia, M. A., & Stamatakis, E. A. (2018) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13082 · Cited by 49
Medication Adherence and its Related Factors in Patients with Type II Diabetes
Gholamaliei, B., Karimi‐Shahanjarini, A., Roshanaei, G., & Rezapur-Shahkolai, F. (2017) · Journal of Education and Community Health · doi:10.21859/jech-02042 · Cited by 47
Grandy, S., Fox, K., & Hardy, É. (2013) · Current Therapeutic Research · doi:10.1016/j.curtheres.2013.06.004 · Cited by 46
Alkerwi, A., Schuh, B., Sauvageot, N., Zannad, F. M., Olivier, A., Guillaume, M., Albert, A., & Larsson, C. (2015) · Journal of Public Health Research · doi:10.4081/jphr.2015.406 · Cited by 44
Rodríguez-Ortiz, D., Reyes-Pérez, A., León, P., Sánchez, H., Mosti, M., Aguilar-Salinas, C. A., Velázquez‐Fernández, D., & Herrera, M. F. (2015) · Surgery · doi:10.1016/j.surg.2015.11.015 · Cited by 26
Adherence to oral hypoglycemic medication among patients with diabetes in Saudi Arabia.
Ahmed, N. O., Abugalambo, S., & Almethen, G. H. (2017) · PubMed Central · Cited by 26
Gheshlagh, R. G., Ebadi, A., Raygani, A. K. V., Nourozi, K., Dalvandi, A., & Mahmoodi, H. (2015) · Iranian Journal of Rehabilitation Research · Cited by 25
Adherence to the Therapeutic Regime in Person with Type 2 Diabetes
Albuquerque, C., Correia, C., & Ferreira, M. (2015) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2015.01.132 · Cited by 17
Esposito, K., Maiorino, M. I., Ciotola, M., Di Palo, C., Scognamiglio, P., Gicchino, M., Petrizzo, M., Saccomanno, F., Beneduce, F., Ceriello, A., et al. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-5-200909010-00004 · Cited by 13
Adherencia a la dieta mediterránea de los pacientes con cardiopatía isquémica
Ferrer, J. T., Riera, I. S., Solórzano, M. C., Cabré, M. G., Tapias, M. G., & Masoliver, C. S. (2014) · Revista Española de Cardiología · doi:10.1016/j.recesp.2014.07.024 · Cited by 11
Dietary Adherence in People with Cardiovascular Risk Factors Living in Northern Iran
روشن, م. م., سالاری, ا., پور, م. ق., & نقشبندی, م. (2017) · doi:10.22088/jbums.19.10.4 · Cited by 11
Adherence to the Mediterranean Diet in Patients With Coronary Artery Disease
Ferrer, J. T., Riera, I. S., Solórzano, M. C., Cabré, M. G., Tapias, M. G., & Masoliver, C. S. (2014) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2014.07.023 · Cited by 9
Mashrouteh, M., Narges, K., & Mohammadhosein, G. (2012) · Journal of Health and Development · Cited by 5
Eroglu, E. I., Cetin, C., Akyol, A., Ayaz, A., & Samur, G. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.06.1425 · Cited by 2
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Muscogiuri, G., Verde, L., Sulu, C., Katsiki, N., Hassapidou, M., Frias-Toral, E., Cucalón, G., Pazderska, A., Yumuk, V. D., Colao, A., et al. (2022) · Current Obesity Reports · doi:10.1007/s13679-022-00481-1 · Cited by 207
Piragine, E., Petri, D., Martelli, A., Calderone, V., & Lucenteforte, E. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12051981 · Cited by 113
The role of depression and diabetes distress in glycemic control: A meta-analysis
Ajele, K. W., & Idemudia, E. S. (2025) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2025.112014 · Cited by 67
Heterocyclic compounds as a magic bullet for diabetes mellitus: a review
Farwa, U., & Raza, M. A. (2022) · RSC Advances · doi:10.1039/d2ra02697j · Cited by 59
Mannan, A., Hasan, M. M., Akter, F., Rana, M. M., Chowdhury, N. A., Rawal, L. B., & Biswas, T. (2021) · Global Health Action · doi:10.1080/16549716.2021.1872895 · Cited by 50
Metadata
- Authors
- Mirahmadizadeh, A., Khorshidsavar, H., Seif, M., & Sharifi, M. H.
- Affiliations
- Shiraz University of Medical Sciences (IR)
- Corresponding author
- Sharifi, Mohammad Hossein
- Venue
- Diabetes Therapy
- Published
- 2020-01-08
- Volume
- 11
- Issue
- 2
- Pages
- 479-494
- ISSN
- 1869-6953 (ISSN-L)
- 1869-6961
- PMC
- PMC6995790
- OpenAlex
- W2999477413
- Cited by
- 111
- References
- 47
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 20 · 2023: 23 · 2022: 21 · 2021: 7 · 2020: 7
- FWCI
- 16.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Shiraz University of Medical Sciences (18110)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, medication adherence, Mediterranean diet adherence, physical activity adherence, HbA1c, associated factors, smoking, obesity, overweight, age, Shiraz, Iranian patients, sex differences, marital status, smoking status
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