Association between medication adherence and glycaemic control among patients with type 2 diabetes in Luzhou: a retrospective cohort study (2018-2023).

Abstract

To evaluate the longitudinal association between medication adherence and glycaemic control among patients with Type 2 diabetes (T2D) in Luzhou City, identify modifiable factors and provide actionable evidence to inform targeted diabetes management strategies. Retrospective cohort study. Western China. Data from 30 508 T2D patients in the Luzhou City Health Information Management System (2018-2023). Primary outcome measure: glycaemic control rate. medication adherence, hypertension comorbidity and lifestyle factors. Patients with consistent adherence achieved significantly higher glycaemic control rates (39.6%, 95% CI 38.8% to 40.4%) compared with intermittent adherents (20.8%, 95% CI 19.9% to 21.7%, p<0.001). Poor adherence to medical advice is a major barrier to effective blood glucose control, particularly among intermittent adherents, reducing their success rate by 29.4% (adjusted odds ratio (aOR)=0.706, 95% CI 0.643 to 0.774). Conversely, male gender (aOR=0.879, 95% CI 0.813 to 0.950) and higher educational attainment (aOR=1.004, 95% CI 1.002 to 1.007) were positively associated with glycaemic control. Additionally, temporary residence status provided a marginal benefit (aOR=1.064, 95% CI 1.013 to 1.117), suggesting potential disparities in access to medical resources between urban and rural areas. While medication adherence remains fundamental for glycaemic control, its association with glycaemic control varied according to hypertension comorbidity and lifestyle factors. These findings advocate for integrated care models that simultaneously address cardiovascular risk factors and promote behavioural modifications, particularly in resource-constrained settings experiencing rapid epidemiological transitions.