Taking diabetes medications as prescribed, exercising and managing weight

June 13, 2017, Kaiser Permanente

People with diabetes who took their medications at least 80 percent of the time and people who exercised four or more times per week were at lower risk for poorly controlled blood sugar, according to a new study published in the American Journal of Pharmacy Benefits.

The study also finds that people who were clinically obese were at higher risk for poorly controlled .

Poorly controlled sugar can lead to complications including kidney disease, retinal damage, heart disease, hospitalization and death, according to the American Diabetes Association.

The ADA estimates that about 29 million Americans have diabetes, and according to the National Health and Nutrition Examination Survey, 21 percent of adults with diabetes have poorly controlled blood sugar.

The study, which included nearly 20,000 from Kaiser Permanente in Oregon and Southwest Washington, is novel because researchers were able to track using Kaiser Permanente's unique electronic health record system, which includes pharmacy refill data. Many prior studies relied on asking patients if they took their medications, which is less reliable than patients' medical records.

"Our physicians can look at a patient's electronic medical record and quickly see how often patients are refilling their diabetes, cholesterol and blood pressure medications. If patients are refilling medications when they're supposed to, they're also likely taking them when they're supposed to," said David Mosen, PhD, lead author and investigator at the Kaiser Permanente Center for Health Research. "During office visits we also ask patients if they are exercising and then enter this information into their medical record."

"It's not that people are willfully not taking their medications, they just forget," said Harry Glauber, MD, co-author and endoctrinologist with Kaiser Permanente. "There's so much focus on new drugs and new technologies to improve , but our study shows we could likely improve outcomes if we help patients do these three things: take their medications as prescribed, increase their exercise and manage their weight."

Researchers examined several lifestyle and demographic factors to determine which were most closely associated with poorly controlled blood sugar. They found that members who took their oral diabetes medications at least 80 percent of the time were 46 percent less likely to have poorly controlled blood sugar, compared to those who took their medications less than 80 percent of the time. Members who exercised four or more times a week were 25 percent less likely to have poorly controlled blood sugar, compared to members who exercised three or fewer times per week.

Researchers also found that people who were clinically obese (a or BMI of 30 or more) were 18 percent more likely to have poorly controlled blood sugar, compared to those who were not obese.

African Americans and other racial and ethnic minorities were also more likely than non-Hispanic whites to have poorly controlled blood sugar. These differences remained even after adjusting for adherence and other lifestyle factors, according to the researchers.

Explore further: Severe hypoglycemia linked to increased risk of death in people with diabetes

Related Stories

Severe hypoglycemia linked to increased risk of death in people with diabetes

March 10, 2017
A single instance of blood sugar falling so low as to require an emergency department visit was associated with nearly double the risk of cardiovascular disease or death, finds a new Johns Hopkins Bloomberg School of Public ...

Health system factors improve medication adherence among seniors with diabetes

March 17, 2015
Specific system-level factors controlled by health care systems - including prescriptions with a medication supply greater than 90 days, mail-order pharmacy use, and lower copayments and out-of-pocket maximums - nearly doubled ...

Diabetes patients do better after surgery when their blood sugar is managed by pharmacists

October 27, 2015
A pharmacy-led glycemic control program is linked to improved outcomes for surgical patients with diabetes and those who develop stress-induced hyperglycemia or high blood sugars as a result of surgery, according to a new ...

Severe low blood sugar occurs often in patients with Type 2 diabetes

July 30, 2013
Patients with diabetes who take certain types of medications to lower their blood sugar sometimes experience severe low blood sugar levels, whether or not their diabetes is poorly or well controlled, according to a new study ...

Personal health record associated with improved medication adherence

January 6, 2014
Patients with diabetes who used an online patient portal to refill medications increased their medication adherence and improved their cholesterol levels, according to a new study in the journal Medical Care.

Blood pressure, cholesterol most important indicators of heart disease risk in diabetics

January 28, 2013
For people with diabetes, meeting the recommended guidelines for blood pressure and cholesterol is even more important than meeting the guidelines for blood sugar control in reducing the risk of heart attack or stroke, according ...

Recommended for you

Healthy fat cells uncouple obesity from diabetes

August 14, 2018
About 422 million people around the world, including more than 30 million Americans, have diabetes. Approximately ninety percent of them have type 2 diabetes. People with this condition cannot effectively use insulin, a hormone ...

'Alarming' diabetes epidemic in Guatemala tied to aging, not obesity

August 14, 2018
The diabetes epidemic in Guatemala is worse than previously thought: more than 25 percent of its indigenous people, who make up 60 percent of the population, suffer from type 2 diabetes or pre-diabetes, suggests a new study ...

Gut reaction linked to type 1 diabetes

August 13, 2018
Understanding the link between diabetes and the gut could lead to the development of new therapies to delay the onset of type 1 diabetes, according to University of Queensland researchers.

Early age of type 1 diabetes diagnosis linked to shorter life expectancy, compared to later diagnosis

August 10, 2018
Life-expectancy for individuals with younger-onset disease is on average 16 years shorter compared to people without diabetes, and 10 years shorter for those diagnosed at an older age

Red blood cells cause cardiovascular injury in type 2 diabetes

August 7, 2018
Harmful effects of substances secreted from red blood cells could explain the increased risk of cardiovascular diseases in patients with type 2 diabetes, the results of two new studies conducted at Karolinska Institutet in ...

Diabetes in bay area Chinese population linked to fat fibrosis

August 6, 2018
A new UC San Francisco study has discovered a key biological difference in how people of European and Chinese descent put on weight—a finding that could help explain why Asians often develop type 2 diabetes at a much lower ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.