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J Diabetes Complications. 2015 Nov-Dec;29(8):1228-33. doi: 10.1016/j.jdiacomp.2015.07.005. Epub 2015 Jul 9.

Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.

Author information

1
Department of Economics, Duke University, 213 Social Sciences Building, Box 90097, Durham, NC, 27708. Electronic address: yiqun.chen@duke.edu.
2
Department of Economics, Duke University, 213 Social Sciences Building, Box 90097, Durham, NC, 27708. Electronic address: fsloan@duke.edu.
3
Department of Economics, Duke University, 213 Social Sciences Building, Box 90097, Durham, NC, 27708. Electronic address: arseniy.yashkin@duke.edu.

Abstract

AIMS:

Analyze relationships between adherence to guidelines for diabetes care - regular screening; physical activity; and medication - and diabetes complications and mortality.

METHODS:

Outcomes were onset of congestive heart failure (CHF), stroke, renal failure, moderate complications of lower extremities, lower-limb amputation, proliferative diabetic retinopathy (PDR), and mortality during follow-up. Participants were persons aged 65+ in the Health and Retirement Study (HRS) 2003 Diabetes Study and had Medicare claims in follow-up period (2004-8).

RESULTS:

Adherence to screening recommendations decreased risks of developing CHF (odds ratio (OR)=0.83; 95% confidence interval (CI): 0.72-0.96), stroke (OR=0.80; 95% CI: 0.68-0.94); renal failure (OR=0. 82; 95% CI: 0.71-0.95); and death (OR=0.86; 95% CI: 0.74-0.99). Adherence to physical activity recommendation reduced risks of stroke (OR=0.64; 95% CI: 0.45-0.90), renal failure (OR=0.71; 95% CI: 0.52-0.97), moderate lower-extremity complications (OR=0.71; 95% CI: 0.51-0.99), having a lower limb amputation (OR=0.31, 95% CI: 0.11-0.85), and death (OR=0.56, 95% CI: 0.41-0.77). Medication adherence was associated with lower risks of PDR (OR=0.35, 95% CI: 0.13-0.93).

CONCLUSIONS:

Adherence to screening, physical activity and medication guidelines was associated with lower risks of diabetes complications and death. Relative importance of adherence differed among outcome measures.

KEYWORDS:

Diabetes complications; Guidelines; Health and Retirement Study; Mortality; Physical activity

PMID:
26316423
PMCID:
PMC4656150
DOI:
10.1016/j.jdiacomp.2015.07.005
[Indexed for MEDLINE]
Free PMC Article

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