Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

Factors Associated with Insulin Adherence among Patients with Type 2 Diabetes: The MOSAIc Study (#268)

Helen Barraclough 1 , Mengdong He 2 , Bradley H. Curtis 1 , Jay Bae 1 , Ayad K. Ali 1 , William H. Polonsky 3 , Lucas Rista 4 , Salem A. Beshyah 5 , Martha M. Funnell 6 , Renan Magalhaes Montenegro Jr 7 , Virginia Fernandes 7 , Seoyoung C. Kim 2
  1. Eli Lilly and Company, Indianapolis, IN, USA
  2. Brigham and Womens Hospital, Boston, MA, USA
  3. Diabetes Behavioral Institute, Del Mar, CA, USA
  4. University Rosario, Rosario, Argentina
  5. Diabetes Clinic, Abu Dhabi, United Arab Emirates
  6. University of Michigan, Ann Arbor, MI, USA
  7. Universidade Federal do Ceará (UFC), Fortaleza-Ceara, Brazil

Although insulin is the most effective glucose lowering therapy, adherence varies widely. Few studies have investigated this issue over an extended period. This analysis identified factors associated with insulin nonadherence within MOSAIc, a 2-year prospective cohort study. Patients with type 2 diabetes (T2D) who were ≥18 year old and taking insulin for ≥3 months in 18 countries were included. Demographic, clinical, and self-reported data were collected at baseline and over 2 years. Insulin nonadherence was defined as missing any insulin injections within the past 7 days of a clinic visit. Multivariable logistic regression and multiple imputation were used in the analyses. Among 2706 patients, mean ± SD age was 62.1 ± 10.8 years, 50% were female, and 608 (29.3%) were nonadherent at the end of study. These patients were younger (p<.0001), had lower diabetes knowledge test scores (p=.04), were likely to be nonadherent at baseline (p<.0001), used mixed insulin (p=.0003), injected >1 time per day (p=.001), had a worse experience with their insulin delivery system (p=.01), and had poor communication with their physicians compared to adherent patients. After adjustment, age and baseline insulin nonadherence remained significantly different between the 2 groups. In conclusion, this study indicates that among patients with T2D utilizing insulin, younger patients with a history of poor adherence are less likely to be adherent over time.