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Medication Adherence and Weight

Does medication type make a difference?… 

Weight gain is a side effect of many diabetes medications, which can lead to patient non-adherence. Decreased adherence is associated with less glycemic control and increases in diabetes-related complications. Previous studies have reported medication adherence among type 2 diabetics to be 60% and lower.

A recent study analyzed data from SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes) to determine if type 2 diabetic adults who experienced weight loss on their diabetic medication had better adherence than those patients who gained weight on their diabetes medication.

Researchers assessed weight change over the one-year period from 2007-2008 in adults with type 2 diabetes from the SHIELD study. Type 2 diabetes patient classification was based on self-report, or having been told by doctor, nurse, or other health care professional. Change in weight was calculated by computing the difference from self-report in the 2008 survey from that reported in the 2007 survey. Researchers defined two distinct drug groups including those associated with weight loss (GLP-1 receptor agonists and metformin), and those associated with weight gain (including TZD’s, insulin, and sulfonylureas).

It was found that the majority of patients lost >1% of body weight (n=746), a fair amount of patients lost ≥3% weight (n=483), some lost ≥5% weight (n=310), with some gaining ≥1% of body weight (n=670). Fewer patients experiencing weight loss were receiving insulin, sulfonylureas, or TZD therapy, as compared to those not experiencing weight loss.

The authors concluded that the patients with type 2 diabetes who experienced weight loss appeared to have significantly better medication adherence and were less likely to be on therapies associated with weight gain such as insulin, TZDs, or sulfonylureas. Additionally, there appeared to be a dose response to weight loss and medication adherence.

Practice Pearls:
  • Previous studies have reported medication adherence among type 2 diabetics to be 60% and lower.
  • Type 2 diabetics experiencing weight loss appear to have significantly better medication adherence and are less likely to be on therapies associated with weight gain such as insulin, TZDs, or sulfonylureas.

 [Grandy, S. et al. Association of Weight Loss and Medication Adherence Among Adults With Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes). Current Therapeutic Research. 2013;25:77-82]