Adherence to self-care practices, glycemic status and influencing factors in diabetes patients in a tertiary care hospital in Delhi

AIM To assess the adherence to self-care practices, glycemic status and influencing factors in diabetes patients. METHODS This was a cross-sectional observational analysis of baseline data from a quasi-experimental study conducted among 375 diabetic patients aged between 18 to 65 years at a major public tertiary care centre in New Delhi, India during February-September' 2016. The Summary of Diabetes Self-care activities measure was used to assess medical adherence in diabetic patients. Open ended questions were used to identify facilitators and inhibitors of medical adherence. RESULTS Mean age of the study subjects was 49.7 +/- 10.2 years. A total of 201 men and 174 women were enrolled in the study. Three hundred nine (82.4%) subjects were adherent to their intake of anti-diabetic medication. On binary logistic regression, education level below primary school completion and absence of hypertension comorbidity were found to be independent predictors of medication non-adherence. Sociocultural resistance was an important factor impeding outdoor exercise among younger women. Knowledge of diabetes in the study subjects was low with mean score of 3.1 +/- 2 ( maximum score = 10). Suboptimal glycemic control was found in 259 (69%) subjects which was significantly more likely in patients on Insulin therapy compared to those on Oral Hypoglycemic agents alone (P < 0.006). DISCUSSION Our study found a large gap existed between self-reported medication adherence and glycemic control. This suggests the need for enhanced physician focus for diabetic patient management.