Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes. A survey in general practice

Background: To address compliance with oral antidiabetic agents and its impact on metabolic control in type 2 diabetic patients treated in general practice. Methods: Prospective assessment of self-reported compliance with a standardized questionnaire in an homogeneous cohort of 11,896 type 2 diabetic patients treated by their general practitioner with one or two oral antidiabetic agents, and analysis of determinants of compliance with treatment (age, diabetes duration, educational level, severity of complications, frequency of antidiabetic oral agents daily dosing). Results: Optimal compliance (no omission) was reported in only 46% of cases. In multivariate analysis, HbA(1c) levels were positively correlated with age, daily dosing frequency of oral antidiabetic agents and low educational level, but not with diabetes duration. Low daily dosing was associated with a better metabolic control. HbA1c levels were associated with compliance with treatment, with a 1.4% mean difference between group with optimal and group with worst compliance. Conclusions: These results suggest the interest of reducing daily dosing frequency of oral antidiabetic agents, in order to improve compliance with treatment and metabolic control.