Garay-Sevilla M E, Nava L E, Malacara J M, Huerta R, Díaz de León J, Mena A, Fajardo M E
Instituto de Investigaciones Médicas, Universidad de Guanajuato, León, Mexico.
J Diabetes Complications. 1995 Apr-Jun;9(2):81-6. doi: 10.1016/1056-8727(94)00021-f.
We carried out a cross-sectional study to investigate factors associated with adherence to diet and medication in non-insulin-dependent diabetes mellitus (NIDDM) patients. A total of 200 patients not seeking treatment from clubs for diabetics from two hospitals in León, Mexico, accepted inclusion. Patients interviewed had a mean age of 58.8 (53.3-56.4, 95% C.I.) years. We evaluated adherence to diet and medication, knowledge on diabetes, social support, family's structure and functioning (with a modified McMaster model), metabolic control, and complications. Stepwise multiple regression procedure showed that adherence to diet was associated with years since diagnosis (p = 0.003) and with social support (p = 0.007). Adherence to medication was associated with social support (p = 0.002), and the age of the spouse (p = 0.016). Adherence to medication was lower in patients from families with rigid control than in the group with Laissez-faire type of control (p = 0.010) or the group with flexible control (p = 0.002). Social support was lower in the group with chaotic control than that in the group with flexible control (p < 0.001). Compliance to diet was associated with peripheral neuropathy and plasma creatinine, and adherence to medication with plasma glucose and peripheral neuropathy. We concluded that (1) adherence to treatment in NIDDM patients is associated with social support; (2) some aspects related to the family, such as the age of the spouse and the control of behavior, were also associated with compliance to treatment; and (3) it is important for the practicing physicians, and for institutional programs, to consider factors associated with adherence to treatment.
我们开展了一项横断面研究，以调查非胰岛素依赖型糖尿病（NIDDM）患者饮食和药物治疗依从性的相关因素。来自墨西哥莱昂市两家医院的200名未在糖尿病患者俱乐部寻求治疗的患者接受了纳入研究。接受访谈的患者平均年龄为58.8岁（53.3 - 56.4岁，95%置信区间）。我们评估了饮食和药物治疗依从性、糖尿病知识、社会支持、家庭结构与功能（采用改良的麦克马斯特模型）、代谢控制及并发症。逐步多元回归分析显示，饮食依从性与确诊年限相关（p = 0.003），与社会支持相关（p = 0.007）。药物治疗依从性与社会支持相关（p = 0.002），与配偶年龄相关（p = 0.016）。在控制严格的家庭中的患者，其药物治疗依从性低于放任型控制家庭组（p = 0.010）或灵活控制家庭组（p = 0.002）。混乱控制家庭组的社会支持低于灵活控制家庭组（p < 0.001）。饮食依从性与周围神经病变和血肌酐相关，药物治疗依从性与血糖和周围神经病变相关。我们得出结论：（1）NIDDM患者的治疗依从性与社会支持相关；（2）家庭的某些方面，如配偶年龄和行为控制，也与治疗依从性相关；（3）对于执业医师和机构项目而言，考虑与治疗依从性相关的因素非常重要。
