ADHERENCE TO TREATMENT AND SOCIAL SUPPORT IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

We carried out a cross-sectional study to investigate factors associat ed with adherence to diet and medication in non-insulin-dependent diab etes mellitus (NIDDM) patients. A total of 200 patients not seeking tr eatment from clubs for diabetics from two hospitals in Leon, Mexico, a ccepted inclusion. Patients interviewed had a mean age of 58.8 (53.3-5 6.4, 95% C.I.) years. We evaluated adherence to diet and medication, k nowledge on diabetes, social support, family's structure and functioni ng (with a modified McMaster model), metabolic control, and complicati ons. Stepwise multiple regression procedure showed that adherence to d iet was associated with years since diagnosis (p = 0.003) and with soc ial support (p = 0.007). Adherence to medication was associated with s ocial support (p = 0.002), and the age of the spouse (p = 0.016). Adhe rence to medication was lower in patients from families with rigid con trol 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 low er in the group with chaotic control than that in the group with flexi ble control (p < 0.001). Compliance to diet was associated with periph eral neuropathy and plasma creatinine, and adherence to medication wit h plasma glucose and peripheral neuropathy. We concluded that (1) adhe rence to treatment in NIDDM patients is associated with social support ; (2) some aspects related to the family, such as the age of the spous e 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 adher ence to treatment.