Medication Adherence and Risks of Mortality and End-Organ Damage in Asian Patients with Type 2 Diabetes: A Cohort Study from Southern Taiwan
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Primary Outcomes
3.2. Secondary Outcomes
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
| T2DM | Type 2 diabetes mellitus |
| MMAS-8 | 8-Item Morisky Medication Adherence Scale |
| ESKD | End-stage kidney disease |
| HbA1c | Glycated hemoglobin |
| eGFR | Estimated glomerular filtration rate |
| LDL | Low-density lipoprotein |
| HR | Hazard ratio |
| CI | Confidence interval |
| BMI | Body mass index |
Appendix A
| Total (n = 26) | n |
|---|---|
| Malignancy (n = 11, 42.3%) | |
| Lung cancer | 4 |
| Hepatocellular carcinoma | 3 |
| Diffuse large B-cell lymphoma | 1 |
| Thymic squamous cell carcinoma | 1 |
| Cholangiocarcinoma | 1 |
| Gastric adenocarcinoma | 1 |
| Cardiovascular events (n = 2, 7.7%) | |
| Acute ischemic stroke | 1 |
| Acute myocardial infarction | 1 |
| Infection (n = 8, 30.8%) | |
| Pneumonia | 3 |
| Urinary tract infection | 2 |
| COVID-19 | 2 |
| Liver abscess | 1 |
| Others (n = 5, 19.2%) | |
| Major trauma | 2 |
| Peptic ulcer perforation | 1 |
| Abdominal aortic aneurysm rupture | 1 |
| Acute pancreatitis | 1 |
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| Good Medication Adherence | Moderate Medication Adherence | Poor Medication Adherence | Total Patients | p Value | |
|---|---|---|---|---|---|
| Total, n | 224 | 89 | 73 | 386 | |
| Age (years) | 65.95 ± 9.61 | 61.42 ± 11.83 | 62.02 ± 11.05 | 64.16 ± 10.62 | <0.001 |
| Male sex, n (%) | 133 (59.4%) | 48 (53.9%) | 39 (53.4%) | 220 (57.0%) | |
| Biochemical Data | |||||
| BMI (kg/m2) | 26.52 ± 3.79 | 26.33 ± 4.36 | 27.22 ± 4.21 | 26.61 ± 4.01 | 0.326 |
| FPG (mg/dL) | 134.19 ± 38.17 | 129.72 ± 31.96 | 136.03 ± 30.40 | 133.50 ± 35.41 | 0.481 |
| HbA1c (%) | 6.90 ± 0.97 | 6.99 ± 0.96 | 7.32 ± 1.21 | 7.01 ± 1.03 | 0.007 |
| ALT (U/mL) | 27.13 ± 14.23 | 27.16 ± 15.67 | 25.79 ± 14.19 | 26.88 ± 14.54 | 0.779 |
| Total cholesterol (mg/dL) | 145.92 ± 29.25 | 167.06 ± 29.55 | 157.47 ± 30.69 | 152.41 ± 67.69 | 0.043 |
| TG (mg/dL) | 107.25 ± 58.75 | 114.73 ± 74.26 | 119.84 ± 79.03 | 111.35 ± 66.74 | 0.325 |
| HDL (mg/dL) | 46.98 ± 12.86 | 48.08 ± 15.26 | 46.76 ± 13.16 | 47.19 ± 13.47 | 0.776 |
| LDL (mg/dL) | 72.86 ± 22.37 | 77.80 ± 22.15 | 80.62 ± 22.28 | 75.47 ± 22.47 | 0.020 |
| eGFR (mL/min/1.73 m2) | 74.41 ± 23.76 | 79.70 ± 24.51 | 79.18 ± 24.47 | 76.53 ± 24.14 | 0.126 |
| UACR (mg/g) | 126.29 ± 491.99 | 78.57 ± 172.52 | 190.44 ± 612.00 | 127.47 ± 467.02 | 0.318 |
| Underlying Diseases, n (%) | |||||
| HTN | 155 (69.2%) | 60 (67.4%) | 46 (63.0%) | 261 (67.6%) | |
| Hyperlipidemia | 191 (85.3%) | 75 (84.3%) | 62 (84.9%) | 328 (85.0%) | |
| CKD | 59 (26.3%) | 26 (29.2%) | 15 (20.5%) | 100 (25.9%) | |
| Good Medication Adherence | Moderate Medication Adherence | Poor Medication Adherence | p Value | |
|---|---|---|---|---|
| Accumulative Event at 5 Years, n (%) | ||||
| Nonfatal MI | 12 (6.69%) | 2 (2.24%) | 5 (6.84%) | 0.351 |
| Heart Failure | 17 (7.58%) | 5 (5.61%) | 5 (6.84%) | 0.856 |
| Renal Failure | 3 (1.33%) | 0 (0%) | 1 (1.36%) | 0.522 |
| Nonfatal Stroke | 10 (4.46%) | 4 (4.49%) | 1 (1.36%) | 0.484 |
| Death | 7 (3.12%) | 8 (8.98%) | 11 (15.06%) | 0.001 * |
| Good Medication Adherence | Moderate Medication Adherence | Poor Medication Adherence | p Value | |
|---|---|---|---|---|
| Change at 5 years | ||||
| HbA1c (%) | 0.19 ± 1.33 | −0.17 ± 1.42 | 0.38 ± 1.81 | 0.150 |
| Data at 5 years | ||||
| eGFR (mL/min/1.73 m2) | 78.23 ± 24.46 | 84.30 ± 24.09 | 76.11 ± 26.79 | 0.210 |
| LDL (mg/dL) | 73.20 ± 22.46 | 76.82 ± 22.64 | 85.18 ± 23.08 | 0.016 * |
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Chen, P.-W.; Lin, M.-C.; Fang, T.-J.; Lee, M.-Y. Medication Adherence and Risks of Mortality and End-Organ Damage in Asian Patients with Type 2 Diabetes: A Cohort Study from Southern Taiwan. Biomedicines 2026, 14, 725. https://doi.org/10.3390/biomedicines14030725
Chen P-W, Lin M-C, Fang T-J, Lee M-Y. Medication Adherence and Risks of Mortality and End-Organ Damage in Asian Patients with Type 2 Diabetes: A Cohort Study from Southern Taiwan. Biomedicines. 2026; 14(3):725. https://doi.org/10.3390/biomedicines14030725
Chicago/Turabian StyleChen, Peng-Wen, Ming-Chieh Lin, Tzu-Jung Fang, and Mei-Yueh Lee. 2026. "Medication Adherence and Risks of Mortality and End-Organ Damage in Asian Patients with Type 2 Diabetes: A Cohort Study from Southern Taiwan" Biomedicines 14, no. 3: 725. https://doi.org/10.3390/biomedicines14030725
APA StyleChen, P.-W., Lin, M.-C., Fang, T.-J., & Lee, M.-Y. (2026). Medication Adherence and Risks of Mortality and End-Organ Damage in Asian Patients with Type 2 Diabetes: A Cohort Study from Southern Taiwan. Biomedicines, 14(3), 725. https://doi.org/10.3390/biomedicines14030725

