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Frederick L Brancati

Publications and source records attributed to Frederick L Brancati.

At least 19 recordsLinked to original sources
PubMed2006

Coffee and sweetened beverage consumption and the risk of type 2 diabetes mellitus: the atherosclerosis risk in communities study.

The authors analyzed data from a prospective, community-based cohort to assess the risk of incident type 2 diabetes mellitus associated with coffee and sweetened beverage consumption. They included 12,204 nondiabetic, middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) Study (1987-1999). Consumption of each beverage was assessed by food frequency questionnaire and classified into categories of cups per day. They found an inverse association, after adjusting for potential confounders, between increased coffee consumption and risk of type 2 diabetes mellitus in men (for > or =4 cups (> or =0.95 liter)/day compared with almost never: hazard ratio = 0.77, p(trend) = 0.02) with no significant association in women (hazard ratio = 0.89, p(trend) = 0.32) using a combination of self-report of physician-diagnosed diabetes, diabetes treatment, and a fasting or nonfasting blood glucose test. When self-reported diabetes or diabetes treatment alone was used, a stronger and significant inverse association was seen in men and women. Sweetened beverage consumption (men: hazard ratio = 1.03, p(trend) = 0.94; women: hazard ratio = 1.01, p(trend) = 0.58) showed no consistent association with the incidence of type 2 diabetes mellitus. In summary, increased coffee consumption was significantly associated with a decreased risk of diagnosed type 2 diabetes mellitus in community-based US adults.

Beverages↗
PubMed2006

Association of social problem solving with glycemic control in a sample of urban African Americans with type 2 diabetes.

The Social Problem-Solving Inventory--Revised, Short Form, was administered to 65 urban African Americans with type 2 diabetes to examine association of generic problem-solving styles and orientation with hemoglobin A1C (A1C). Eighty-five percent of participants had total social problem-solving scores in the Average range or higher. In linear regression models adjusted for education, each interquartile increase in impulsive/careless score was associated with a 0.82 increase in A1C (%) (p = 0.01), and each interquartile increase in avoidant score was associated with a 1.62 increase in A1C (%) (p = 0.004). After adjusting for depressive symptoms, the association of impulsive/careless style with A1C was attenuated, while the association of avoidant problem solving with A1C remained significant (p = 0.01). Associations of rational problem-solving style, positive orientation, and negative orientation with A1C and health behaviors were not statistically significant. Ineffective problem-solving styles may prove to be important targets for intervention to improve glycemic control.

Adult↗
PubMed2006

Common carotid arterial interadventitial distance (diameter) as an indicator of the damaging effects of age and atherosclerosis, a cross-sectional study of the Atherosclerosis Risk in Community Cohort Limited Access Data (ARICLAD), 1987-89.

BACKGROUND: The effect of age on common carotid artery diameter is unclear for varying atherosclerosis risk levels. METHODS: Cross-sectional data from the Atherosclerosis Risk in Communities Limited Access Data set were used to estimate the association of age with B-mode ultrasound common carotid artery diameter for three atherosclerosis risk levels. Based on information from clinical examinations, B-mode ultrasounds, questionnaires, blood and other tests, participants were categorized into three groups: pre-existing disease (prevalent stroke and/or coronary heart disease), high risk group (no pre-existing disease, but prevalent diabetes, hypertension, plaques/shadowing, body mass index > or = 30, current smoking, or hyperlipidemia), and a low risk group (no pre-existing disease, no plaques/shadowing, and no major elevated risk factors). Multivariable linear regression analyses modeled the common carotid artery diameter relationship with age. RESULTS: Age was positively and significantly associated with common carotid artery diameter after risk factor adjustment in the overall sample, but age had a larger effect among persons with evidence of atherosclerosis (interaction p < 0.05). Each year of older age was associated with 0.03 mm larger diameter/year among persons with pre-existing disease, with 0.027 mm larger diameter/year in the high risk group, but only 0.017 mm/year among the low risk group. Results were qualitatively similar using plaques/shadowing status to indicate atherosclerosis severity. CONCLUSION: The significant impact of age on common carotid artery diameter among low risk, middle-aged, black and white men and women suggests arterial remodelling may occur in the absence of identified risk factors. The significantly larger impact of age among persons with, compared to persons without identified atherosclerosis or its risk factors, suggests that arterial remodelling may be an indicator of exposure duration.

Adult↗
PubMed2006

Perceived body image among African Americans with type 2 diabetes.

OBJECTIVE: To assess current, desired and best body image in the opposite sex and examine correlates of body image dissatisfaction. METHODS: We conducted a cross-sectional analysis at baseline of 185 (141 women, 44 men) African Americans with type 2 diabetes in Project Sugar 1, a randomized controlled trial of primary care-based interventions to improve diabetic control. RESULTS: Women had a significantly lower desired body image compared to their current body image (BMI approximately 27.7 versus approximately 35.3). Men preferred a body image for women that was similar to the body image that women desired for themselves (BMI approximately 28.3 versus approximately 27.7). Significant correlates of body image dissatisfaction included self-perception of being overweight and attempting weight-loss (P < 0.05). PRACTICAL IMPLICATIONS: Among overweight and obese African-American women with diabetes, it is important to first address an individual's perceived body image, perceived risk of disease, desired body image, and weight-loss perceptions. In addition to the aesthetic benefits of weight-loss, there is a need to focus on the health benefits in order to intervene among African Americans with diabetes.

Adult↗
PubMed2006

Lifetime weight patterns in male physicians: the effects of cohort and selective survival.

OBJECTIVE: The natural history of lifetime weight change is not well understood because of conflicting evidence from cross-sectional and longitudinal studies. Cross-sectional analyses find that adult weight is highest at approximately 60 years of age and lower thereafter. Longitudinal analyses have not found this pattern. Our objective was to test whether cohort effects and selective survival may explain the differences observed between cross-sectional and longitudinal studies. RESEARCH METHODS AND PROCEDURES: We analyzed data on white men from the Johns Hopkins Precursors Study (n = 1197). Weight and height were measured at enrollment during medical school. The Precursors Study collected subsequent weight measurements by self-report and follows all participants for mortality. RESULTS: In preliminary analyses that ignored cohort and survival effects, average weight increased 0.16 kg/yr to age 65 (p < 0.001) and declined 0.10 kg/yr thereafter (p = 0.002). When controlling for differing rates of weight change by cohort and survival group, the apparent decline after 65 years of age was mostly explained. DISCUSSION: These data suggest that, in white men, weight increases steadily until age 65 and then plateaus. These findings emphasize the necessity of longitudinal rather than cross-sectional data to describe lifetime weight patterns.

Age Factors↗
PubMed2006

Role of a proline insertion in the insulin promoter factor 1 (IPF1) gene in African Americans with type 2 diabetes.

African Americans have twice the prevalence of type 2 diabetes as Caucasians and much greater genetic diversity. We identified an inframe insertion of a proline in the insulin promoter factor 1 (IPF1) gene (InsCCG243), which was relatively common (minor allele frequency approximately 0.08) in African Americans and showed a trend to association with type 2 diabetes in preliminary studies. An earlier French study identified InsCCG243 as a cause of autosomal dominant diabetes. To determine the role of this variant in African Americans, we examined an additional population from North Carolina (n = 368) and a subset of African-American participants from the Atherosclerosis Risk in Communities (ARIC) study (n = 1,741). We also looked for segregation in 66 African-American families and for a role in insulin secretion in 112 nondiabetic subjects. InsCCG243 did not increase the risk of type 2 diabetes (P = 0.16 in North Carolina; P = 0.97 in the ARIC study) and did not segregate with type 2 diabetes in families. However, we found suggestive evidence for reduced insulin response to glucose (P = 0.05). Neither indirect measures of beta-cell mass nor beta-cell compensation were altered (P > 0.1). InsCCG243 does not act in a dominant, highly penetrant fashion in African Americans and is not a significant risk factor for type 2 diabetes in this population.

Black or African American↗
PubMed2006

Short stature and the risk of adiposity, insulin resistance, and type 2 diabetes in middle age: the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994.

OBJECTIVE: To investigate the association between stature-related measurements (height, leg length, and leg length-to-height ratio) and adiposity, insulin resistance, and glucose intolerance. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional analysis of a nationally representative sample of 7,424 adults aged 40-74 years, from the Third National Health and Nutrition Examination Survey (1988-1994). The main outcome measures were percent body fat, homeostasis model assessment of insulin resistance (HOMA-IR), and glucose intolerance based on the World Health Organization's 1985 criteria for an oral glucose tolerance test. RESULTS: Shorter height and leg length, and lower leg length-to-height ratio, were associated with higher percent body fat, especially in women. Lower leg length-to-height ratio was associated with greater insulin resistance estimated by HOMA-IR. In multinomial regression models adjusting for potential confounders, including percent body fat, the relative prevalence of type 2 diabetes per 1-SD lower values in height, leg length, and leg length-to-height ratio were 1.10 (95% CI 0.94-0.29), 1.17 (0.98-1.39), and 1.19 (1.02-1.39), respectively. CONCLUSIONS: Our study supports the hypothesis that adult markers of prepubertal growth, especially leg length-to-height ratio, are associated with adiposity, insulin resistance, and type 2 diabetes in the general U.S. population.

Adipose Tissue↗
PubMed2006

The burden and treatment of diabetes in elderly individuals in the u.s.

OBJECTIVE: To assess the prevalence of diabetes, distinguishing between elderly individuals with diabetes diagnosed in middle age ("middle age-onset diabetes") from elderly individuals with recently diagnosed diabetes ("elderly onset diabetes") and to assess the burden of complications and control of cardiovascular risk factors in these groups. RESEARCH DESIGN AND METHODS: We analyzed data from 2,809 elderly individuals from the 1999-2002 National Health and Nutrition Examination Survey, a cross-sectional nationally representative survey of the civilian noninstitutionalized population of the U.S. RESULTS: Among adults aged >/=65 years, the prevalence of diagnosed diabetes was 15.3%, representing 5.4 million individuals in the U.S. The prevalence of undiagnosed diabetes was 6.9% or 2.4 million individuals. Elderly individuals with middle age-onset diabetes had a much greater burden of microvascular disease but have a similar burden of macrovascular disease compared with individuals with elderly onset diabetes. Elderly individuals with middle age-onset diabetes had substantially worse glycemic control (proportion of individuals with HbA(1c) >7% = 59.9%) compared with either elderly onset (41.6%) or nonelderly individuals with diabetes (55.3%). Individuals with elderly onset diabetes were also less likely to be taking glucose-lowering medications. CONCLUSIONS: In this study, we documented a high prevalence of diabetes among elderly individuals and high rate of poor glycemic control in this population. Individuals with middle age-and elderly onset diabetes appear to represent distinct groups with differing burdens of disease and possibly differing treatment goals. Future studies of diabetes in elderly individuals may need to consider stratification based on age of diagnosis.

Adult↗
PubMed2006

Delayed diagnosis of incident type 2 diabetes mellitus in the ARIC study.

OBJECTIVES: To estimate delays to physician diagnosis of incident cases of type 2 diabetes mellitus (DM) and to identify predictors of delayed diagnosis. STUDY DESIGN: The Atherosclerosis Risk in Communities (ARIC) study, an ongoing population-based prospective study of 15 792 middle-aged adults. METHODS: The study population comprised 298 adults with incident DM. Exposures were demographic, socioeconomic, health behavior, and clinical risk factors before the onset of type 2 DM. The main outcome was the delay from onset of DM to physician diagnosis. RESULTS: Among 298 ARIC participants with incident type 2 DM at visit 2 of the study, the median delay from onset of DM to physician diagnosis was 2.4 years. More than 7% of incident cases remained undiagnosed for at least 7.5 years after the onset of disease. Compared with individuals with promptly diagnosed incident DM, those with delayed diagnosis were more likely to be obese before the onset of DM (P = .003), less likely to have heart disease at baseline (P = .02 for trend), less likely to have seen their physician in the past year (P = .005 for trend), and had a slower rise in fasting hyperglycemia (P = .04). Neither demographic characteristics nor study site predicted delayed diagnosis. CONCLUSIONS: Even with a de facto screening program, diagnosis of incident type 2 DM in the community is typically delayed for 2 years and sometimes as long as 7 years or more. The associated risk factors suggest deficiencies in organizational processes, physician actions, and patient access or acceptance of the diagnosis.

Atherosclerosis↗
PubMed2005

A systematic review of interactive computer-assisted technology in diabetes care. Interactive information technology in diabetes care.

BACKGROUND: Excellent diabetes care and self-management depends heavily on the flow of timely, accurate information to patients and providers. Recent developments in information technology (IT) may, therefore, hold great promise. OBJECTIVE: To determine, in a systematic review, how emerging interactive IT has been used to enhance care for adults with type 2 diabetes. METHOD: Eligible studies were randomized controlled trials (RCTs) and observational studies (both before-after designs and post-intervention assessments) focused on computer-assisted interactive IT that included > or =10 adults with diabetes (> or =50% type 2) and reported in English. We searched 4 electronic databases (up to 2003) using terms for diabetes and technology, reviewed bibliographies, and handsearched Diabetes Care (January 1990 to February 2004). Two reviewers independently selected articles and worked serially on data extraction with adjudication of discrepancies by consensus. RESULTS: There were 26 studies (27 reports): internet (n=6; 3 RCTs), telephone (n=7; 4 RCTs), and computer-assisted integration of clinical information (n=13, 7 RCTs). The median (range) sample size was 165 (28 to 6,469 participants) for patients and 37 (15 to 67) for providers; the median duration was 6 (1 to 29) months. Ethnic minorities or underserved populations were described in only 8 studies. Six of 14 interventions demonstrated moderate to large significant declines in hemoglobin A1c levels compared with controls. Most studies reported overall positive results and found that IT-based interventions improved health care utilization, behaviors, attitudes, knowledge, and skills. CONCLUSIONS: There is growing evidence that emerging IT may improve diabetes care. Future research should characterize benefits in the long term (>1 year), establish methods to evaluate clinical outcomes, and determine the cost-effectiveness of using IT.

Biomedical Technology↗
PubMed2005

Computer and internet use among urban African Americans with type 2 diabetes.

Previous studies have identified a "digital divide" between African Americans and whites, with African Americans having substantially lower rates of Internet use. However, use of the Internet to access health information has not been sufficiently evaluated in this population. Therefore, we conducted a telephone survey to determine the prevalence of computer and Internet use among 457 African American adults with type 2 diabetes. Participants were 78% female, with a mean age of 57 +/- 11 years, and about one-third had a yearly income % $7,500. Forty percent of the participants reported having a computer at home and 46% reported knowing how to use a computer. Most participants (58%) reported that they had, at some point, used a computer, and of those, 40% reported that they used the computer to find health information. In a stratified analysis, participants with lower education levels (<high school) were less likely to have a computer; older participants, men, and individuals with lower education levels were less likely to know how to use a computer and to use it to search for health information (all P < .05). Nonetheless, of the participants who did not know how to use a computer, 66% reported that they would be willing to learn. In addition, 82% reported that they had friends or family in the neighborhood who would let them use a computer. Furthermore, 89% of participants reported that they would use a computer program to manage their diabetes if it were offered free of charge. These data show promise for the willingness of this under-served population to use computers and access health information using the Internet. New programs are needed to explore Internet-based interventions to improve self-management and diabetes care among African Americans.

Adult↗
PubMed2005

Anger temperament is modestly associated with the risk of type 2 diabetes mellitus: the Atheroslcerosis Risk in Communities Study.

OBJECTIVE: Trait anger has been shown to predict coronary heart disease; however, there are no prior studies evaluating anger as a risk factor for type 2 diabetes. The objective of this study was to determine if anger proneness predicted type 2 diabetes using prospective analyses. METHODS: We analyzed data on trait anger, assessed by questionnaire, in a longitudinal, bi-racial cohort study of 11,615 initially non-diabetic adults aged 48-67, who were subsequently followed for 6 years for the development of type 2 diabetes. RESULTS: There was no relation between overall trait anger and the subsequent risk of diabetes; however, individuals in the highest tertile of trait anger temperament scores had a 34% increased risk of developing diabetes compared to those in the lowest tertile (Relative hazard [RH] = 1.34; 95% confidence interval: 1.10, 1.62), following adjustment for age, race, gender, and education. The relation between anger temperament and diabetes remained significant following adjustment for behavioral factors (smoking, physical activity, and caloric intake) (RH = 1.31; 95% CI: 1.08, 1.60) but was non-significant after additional adjustment for waist-to-hip ratio and body-mass index (RH = 1.18; 95% CI: 0.97, 1.44). CONCLUSIONS: While we found no relation between overall trait anger and incident diabetes, persons who had higher anger temperament subscale scores had a slightly increased risk of type 2 diabetes, which was largely explained by adiposity. Anger temperament may deserve further attention as a potential risk factor for type 2 diabetes.

Aged↗
PubMed2005

Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study.

BACKGROUND: Chronic hyperglycemia has been hypothesized to contribute to coronary heart disease (CHD), but the extent to which hemoglobin A(1c) (HbA(1c)) level, a marker of long-term glycemic control, is independently related to CHD risk is uncertain. METHODS: We conducted a prospective case-cohort study of 1321 adults without diabetes and a cohort study of 1626 adults with diabetes from the Atherosclerosis Risk in Communities Study. Using proportional hazards models, we assessed the relation between HbA(1c) level and incident CHD during 8 to 10 years of follow-up. RESULTS: In adults with diabetes, the relative risk (RR) of CHD was 2.37 (95% confidence interval [CI], 1.50-3.72) for the highest quintile of HbA(1c) level compared with the lowest after adjustment for CHD risk factors. In persons without diabetes, the adjusted RR of CHD in the highest quintile of HbA(1c) level was 1.41 (95% CI, 0.90-2.30); however, there was evidence of a nonlinear relationship in this group. In nondiabetic adults, HbA(1c) level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P<.001). In diabetic adults, the risk of CHD increased throughout the range of HbA(1c) levels. In the adjusted model, the RR of CHD for a 1-percentage point increase in HbA(1c) level was 2.36 (95% CI, 1.43-3.90) in persons without diabetes but with an HbA(1c) level greater than 4.6%. In diabetic adults, the RR was 1.14 (95% CI, 1.07-1.21) per 1-percentage point increase in HbA(1c) across the full range of HbA(1c) values. CONCLUSION: Elevated HbA(1c) level is an independent risk factor for CHD in persons with and without diabetes.

Blood Glucose↗
PubMed2005

Risk factors for peripheral arterial disease incidence in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND: Some risk factors for peripheral arterial disease (PAD) have been identified, but little information is available on PAD risk factors in individuals with diabetes. METHODS: Using data from the Atherosclerosis Risk in Communities (ARIC) Study, we assessed the relation of traditional and non-traditional risk factors with the risk of PAD in 1651 participants with diabetes, but not PAD, at baseline. Incident PAD was defined as an ankle-brachial index (ABI)<0.9 assessed at regular examinations; hospital discharge codes for PAD, amputation, or leg revascularization; or claudication assessed by annual questionnaire. RESULTS: Over a mean of 10.3 years of follow-up, 238 persons developed incident PAD identified, yielding a PAD event rate of 13.9 per 1000 person years. Adjusted for sex, age, race, and center, the risk of developing PAD was increased 1.87-fold (95% confidence interval (95% CI): 1.36-2.57) in persons who were current smokers versus non-smokers, 2.27-fold (95% CI: 1.57-3.26) for baseline coronary heart disease (CHD) versus no baseline CHD, and 1.75-fold (95% CI: 1.18-2.60) for the highest quartile versus lowest quartile of triglycerides. We found no evidence of an association with other blood lipids or hypertension. Compared with the lowest quartiles, comparably-adjusted relative risks for the highest quartiles were 1.60 (95% CI: 1.10-2.33) for waist-to-hip ratio, 2.52 (95% CI: 1.70-3.73) for fibrinogen, 1.70 (95% CI: 1.17-2.47) for factor VIII, 1.73 (95% CI: 1.18-2.54) for von Willebrand factor, 2.15 (95% CI: 1.43-3.24) for white blood cell count, 1.81 (95% CI: 1.19-2.74) for serum creatinine, 0.55 (95% CI: 0.37-0.83) for serum albumin, and 2.73 (95% CI: 1.77-4.22) for carotid intima-media thickness. Persons who had a prior history of diabetes and were taking insulin had a relative risk of 1.97 (95% CI: 1.35-2.87) for future PAD events, compared with those with newly identified diabetes at baseline. In our final multivariable model, current smoking, prevalent CHD, elevated fibrinogen and carotid IMT, and a prior history of diabetes with insulin treatment were independently associated with greater PAD incidence. CONCLUSION: These markers might be useful to identify individuals with diabetes at particular risk for PAD.

Arteriosclerosis↗
PubMed2005

Assessment of medical school institutional review board policies regarding compensation of subjects for research-related injury.

PURPOSE: Although the Institute of Medicine (IOM) calls for research organizations to compensate subjects for research-related injury, administrators may fear that candid presentation of such policies would create financial risk. We hypothesized that informed consent language at U.S. medical schools would be particularly complex and fall short of IOM goals, especially for projects without industry sponsorship. METHODS: Medical school websites (N = 123) were surveyed for informed consent language for research-related injury. Text was extracted from 113 sites (92%) and evaluated for details regarding financial liability for research-related injury. When sufficient template text was available (n = 106), the readability of liability policies was compared with the readability of other standardized passages using Flesch-Kincaid analysis. RESULTS: Coverage for medical bills is offered at 61% (23/38) of schools when there is an industry sponsor as compared with 22% (22/102) when there is none (P <0.001). When coverage is offered in studies with no industry sponsor, it is limited to emergency bills in half (11/22) of these policies. Seventy-two percent (81/113) of medical school consent forms specifically rule out the possibility of monetary compensation. The mean (+/- SD) reading grade level of liability text in consent forms is higher than that in other template paragraphs (11.5 +/- 1.4 vs. 10.6 +/- 1.4; P = 0.0001). CONCLUSION: Federally funded research at most U.S. medical schools is conducted with consent form language that is particularly complex and that fails to protect subjects from the financial burden of research-related injury. Few schools meet IOM standards.

Biomedical Research↗
PubMed2005

Nephrotic range proteinuria and CD4 count as noninvasive indicators of HIV-associated nephropathy.

PURPOSE: Human immunodeficiency virus (HIV)-associated nephropathy is a common and serious cause of progressive renal insufficiency in patients with HIV, frequently presenting with nephrotic range proteinuria. The purpose of this study is to document the histopathologic diagnoses seen in HIV-positive patients with and without nephrotic range proteinuria and to evaluate the predictive value of both nephrotic range proteinuria and CD4 count in diagnosing HIV-associated nephropathy. METHODS: We performed a cross-sectional, single-center study of all 107 HIV-positive patients who had both a renal biopsy and urine protein measurement between 1995 and 2002. Nephrotic range proteinuria was defined as a urine protein-to-creatinine ratio > 3 or a 24-hour urine protein > 3 g. Clinical and laboratory characteristics of those patients with and without HIV-associated nephropathy were compared. Sensitivity, specificity, and positive and negative predictive values of nephrotic range proteinuria in the diagnosis of HIV-associated nephropathy were determined. RESULTS: Fifty-five biopsied patients had nephrotic range proteinuria, among whom 29 (53%) were diagnosed with HIV-associated nephropathy. Among the remaining patients, 12 had non-HIV-associated nephropathy focal segmental glomeruloscerlosis, 3 had membranoproliferative glomerulonephritis, 2 had AA Amyloid, 2 had diabetic nephropathy, and 7 had other diagnoses. Sensitivity, specificity, and positive and negative predictive values of nephrotic proteinuria in the diagnosis of HIV-associated nephropathy were 73%, 61%, 53%, and 79%, respectively. The patients with HIV-associated nephropathy had a significantly higher creatinine (8.2 mg/dL vs 2.5 mg/dL, P < .001) and a lower CD4 count (158 count/mm3 vs 349 count/mm3, P < .01) at the time of biopsy. Although significantly more patients with HIV-associated nephropathy had a CD4 count below 200 (P = .03), among those with a CD4 count below 200, 10 of 30 patients (33%) had diagnoses other than HIV-associated nephropathy. Injection drug use, presence of hepatitis C, and hypertension were not associated with HIV-associated nephropathy. CONCLUSION: Our results suggest that HIV patients with nephrotic range proteinuria warrant a kidney biopsy because the presence of nephrotic range proteinuria, even in the presence a low CD4 count, does not establish the diagnosis of HIV-associated nephropathy.

Adult↗
PubMed2005

Medication adherence and diabetes control in urban African Americans with type 2 diabetes.

In 181 urban African Americans with Type 2 diabetes, medication adherence was assessed using a measure designed specifically for an urban, impoverished sociodemographic population. Hemoglobin A-sub(1c), blood pressure and cholesterol levels, medication-related beliefs, and depression were assessed. Seventy-four percent of the sample reported adherence to diabetes medication. Adherence, adjusted for age, was associated with lower hemoglobin A-sub(1c). The specific behaviors associated with poorer diabetes control were forgetting to take medications and running out of medications. Knowledge of blood glucose goals differed for adherers and nonadherers. Blood pressure and cholesterol medication adherence rates were not associated with actual levels of blood pressure or lipids, respectively. These data suggest that specific medication-taking behaviors are important to diabetes control and constitute logical targets for interventions. ((c) 2005 APA, all rights reserved).

Adult↗