Disabilities, Type 2 Diabetes
Conditions
Keywords
medication adherence
Brief summary
Individuals with disabilities and type 2 diabetes tend to have worse clinical outcomes. To identify modifiable factors that may improve these outcomes, the investigators evaluated the role of medication adherence. A retrospective, cohort study was conducted using data from the Korean National Health Insurance Service (K-NHIS) database.
Detailed description
Type 2 diabetes mellitus (T2DM) is a well-established risk factor for cardiovascular disease (CVD). In recent years, self-care has become a central component of diabetes management, with growing emphasis on medication adherence, physical activity, and lifestyle modifications to reduce CVD risk and improve long-term outcomes. As a result, limited capacity for self-care has been increasingly recognized as a major contributor to health disparities. Approximately 25% of individuals with disabilities have T2DM, and those with physical or mental impairments often face substantial barriers to effective self-management. These challenges-including limited mobility and reduced access to health information-can lead to poor glycemic control and heightened cardiovascular risk. However, most prior studies have primarily focused on describing the elevated risk of CVD in individuals with disabilities. Whether suboptimal medication adherence mediates the association between disability and cardiovascular outcomes remains unclear. Therefore, this study aims to compare medication adherence between patients with and without disabilities and to assess whether differences in adherence contribute to disparities in the incidence of CVD.
Interventions
BEHAVIORALNo adherence group
Patients with poor adherence was defined as medication possession ratio(MPR) \<50%.
BEHAVIORALAdherence group
Patients with good adherence was defined as medication possession ratio(MPR) ≥50%.
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients who newly diagnosed T2DM between between January 1, 2010, and December 31, 2023
Exclusion criteria
* individuals with a history of MI, stroke, percutaneous coronary intervention, peripheral arterial disease, chronic kidney disease, or cancer before the diagnosis of diabetes were excluded. * individuals with who already had diabetics related complication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Major adverse cardiac and cerebrovascular events (MACCE) | 10 years after diagnosed T2DM | Composite of MI, ischemic stroke, hemorrhagic stroke, and all-cause mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diabetic neuropathy | 10 years after diagnosed T2DM | Nerve damage resulting from DM |
| Diabetic foot without amputation | 10 years after diagnosed T2DM | Diabetic foot complications, such as ulcers, infections, or gangrene, without any lower-extremity amputation |
| Diabetic foot with amputation | 10 years after diagnosed T2DM | Diabetic foot complications who have undergone lower-limb amputation |
| Proliferative diabetic retinopathy | 10 years after diagnosed T2DM | Advanced stage of diabetic retinopathy, marked by the formation of new blood vessels (neovascularization) on the retina or optic disc, which can lead to vitreous hemorrhage, tractional retinal detachment, and vision loss. |
| Non-proliferative diabetic retinopathy | 10 years after diagnosed T2DM | Early stage of diabetic retinal disease, characterized by microaneurysms, intraretinal hemorrhages, and hard exudates without the presence of neovascularization. |
Outcome results
None listed