Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.

Journal Article (Journal Article)


Analyze relationships between adherence to guidelines for diabetes care - regular screening; physical activity; and medication - and diabetes complications and mortality.


Outcomes were onset of congestive heart failure (CHF), stroke, renal failure, moderate complications of lower extremities, lower-limb amputation, proliferative diabetic retinopathy (PDR), and mortality during follow-up. Participants were persons aged 65+ in the Health and Retirement Study (HRS) 2003 Diabetes Study and had Medicare claims in follow-up period (2004-8).


Adherence to screening recommendations decreased risks of developing CHF (odds ratio (OR)=0.83; 95% confidence interval (CI): 0.72-0.96), stroke (OR=0.80; 95% CI: 0.68-0.94); renal failure (OR=0. 82; 95% CI: 0.71-0.95); and death (OR=0.86; 95% CI: 0.74-0.99). Adherence to physical activity recommendation reduced risks of stroke (OR=0.64; 95% CI: 0.45-0.90), renal failure (OR=0.71; 95% CI: 0.52-0.97), moderate lower-extremity complications (OR=0.71; 95% CI: 0.51-0.99), having a lower limb amputation (OR=0.31, 95% CI: 0.11-0.85), and death (OR=0.56, 95% CI: 0.41-0.77). Medication adherence was associated with lower risks of PDR (OR=0.35, 95% CI: 0.13-0.93).


Adherence to screening, physical activity and medication guidelines was associated with lower risks of diabetes complications and death. Relative importance of adherence differed among outcome measures.

Full Text

Duke Authors

Cited Authors

  • Chen, Y; Sloan, FA; Yashkin, AP

Published Date

  • November 2015

Published In

Volume / Issue

  • 29 / 8

Start / End Page

  • 1228 - 1233

PubMed ID

  • 26316423

Pubmed Central ID

  • PMC4656150

Electronic International Standard Serial Number (EISSN)

  • 1873-460X

International Standard Serial Number (ISSN)

  • 1056-8727

Digital Object Identifier (DOI)

  • 10.1016/j.jdiacomp.2015.07.005


  • eng