Side Effects could Disrupt Adherence to Diabetic Medication

Type 2 diabetes patients who are prescribed metformin may not stick to the regular intake of medicine due to side effects. The findings of this study are further discussed in the Journal of Diabetes, Obesity and Metabolism//. Researchers from the University of Surrey examined in detail how likely 1.6 million people with Type 2 diabetes were to take their medication. The study combined data from clinical trials and observational studies looking at adherence rates for both tablet and injectable medicines.

They found that those who took metformin, the most commonly prescribed drug to treat Type 2 diabetes, were the least likely to take the required dosages compared to other diabetes drugs. It was discovered that 30 percent of metformin doses prescribed to patients are not taken compared to 23 percent of sulfonylureas (gliclazide) and 20 percent for pioglitazone.

Interestingly, DPP4 inhibitors (gliptins), one of the newer medication classes have the highest rates of adherence, with only 10 to 20 percent of medication doses not taken. When comparing injectable medications, it was found that patients are twice as likely to stop taking GLP1 receptor agonists (such as exenatide) compared with insulin.

Researchers believe that the variance in adherence rates are in part due to side effects of the different drugs. Metformin commonly causes gastrointestinal symptoms such as diarrhea and flatulence, whereas DPP4 inhibitors are better tolerated by the body. It is also thought that having to take the multiple doses a day required for some drugs may have an impact on people taking the required medication.

Dr. Andy McGovern, a Clinical Researcher at the University of Surrey, said: "The importance of diabetes patients taking their prescribed medication cannot be underestimated. A failure to do so can lead to complications in their condition including eye disease and kidney damage. Medication which is not taken does no good for the patient but still costs the NHS money, so this is an important issue".

"We have known for a long time that a lot of medication prescribed for chronic diseases never actually get taken. What this latest research suggests is that patients find some of these medication classes much easier to take than others" said Dr. Andy McGovern.

Advertisement

"I urge anyone who is struggling to take their medication as prescribed, whether this is because of side effects or because the schedule is too complicated, to discuss this openly with their doctor or nurse. Fortunately for type 2 diabetes we have lots of treatment options and switching to a different medication class which is easier to could provide an easy way to improve adherence. I would also encourage doctors and nurses to actively ask their patients about medication adherence." said Dr. McGovern

Figures from Public Health England report that 3.8 million people in the UK have diabetes, with approximately 90 percent suffering from Type 2. It is estimated that the condition is a contributing factor in 22,000 early deaths in the UK and costs the NHS £8.8billion every year.

Data for this article was extracted from 48 studies, of these 25 compared oral therapies, 19 compared injectable therapies, three included a comparison between oral and injectable therapies and one which compared an oral to an inhaled agent.

Source-Eurekalert