Author(s)

Sarwar Malik^1*, Rabia Basit², Sabahat Naz³, Minaz Mawani⁴, Muhammad Qamar Masood⁵, Jaweed Akhter⁵

¹MBBS, FCPS (Medicine), FCPS (Endocrinology), Fellowship in Diabetes, Metabolism and Endocrinology, Department of Medicine, Federal Govt. Polyclinic Hospital, Islamabad, Pakistan.
²MBBS, FCPS (Medicine), Fellowship in Diabetes, Metabolism and Endocrinology, Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan.
³MSc (Food & Nutrition), Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan.
⁴MSc (Epidemiology and Biostatistics), Department of Medicine, Aga Khan University, Karachi, Pakistan.
⁵MBBS, FACE, Diplomat American Board of Internal Medicine and Endocrinology, Section of Endocrinology, Department of Medicine, Aga Khan University, Karachi, Pakistan.

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease that has become a major health care concern, especially in developing countries like Pakistan. Lifestyle modification and appropriate pharmacotherapy are shown to improve blood glucose levels, lipid abnormalities and blood pressure. It is not known how many patients adhere to advice and drugs prescribed. This study aimed to determine adherence to lifestyle and therapeutic advice. Methods: A cross sectional hospital based study was conducted among patients attending the diabetic clinic at the Aga Khan University Hospital, using a structured questionnaire. Adult patients with T2DM and with at least one year duration of diabetes were included in the study. Results: Participants were aged between 32 and 92 years old with a mean age of 55.7 years old (SD ± 10.7). Mean duration of diabetes was 10.7 years old (SD ± 7.7). Majority (94%) of the patients were literate. Around half (47.3%) of the patients have had achieved glycemic target (HbA1c < 7%). Above target glycemic control was more common among patients with ischemic heart disease (68.1%), neuropathy (64.8%) and those on insulin (62.5%). Self-reported non-adherence for blood sugar monitoring (9.5%), physical activity (61.7%), tobacco use (43.4%) and foot care (43.9%) were noted. About 25% of the participants were not fully adherent to dietary advice. None of the patients from our study reported non-adherence to medications. Good adherence to physical activity was found in males with college degree. The highest percentage of tobacco use (33.3%) was reported among businessmen. Conclusion: We noted low adherence to advice for physical activity, tobacco use and SMBG, but a high adherence to prescribed medications and insulin. This was a selected group visiting a teaching hospital. This will need to be studied further in the community and efforts are required to motivate patients.

Type 2 Diabetes Mellitus, Adherence, Lifestyle advice, Treatment

Malik, S. , Basit, R. , Naz, S. , Mawani, M. , Masood, M. and Akhter, J. (2016) Adherence to Lifestyle Advice and Treatments in Pakistani Patients with Type 2 Diabetes Mellitus. Journal of Diabetes Mellitus, 6, 49-57. doi: 10.4236/jdm.2016.61006.