Compliance in diabetes mellitus: A self‐assessment study

Abstract

The self‐assessed compliance of 100 randomly‐selected diabetics (42 males, 58 females: age range 14–83 years) attending the Hammersmith Hospital outpatient department was examined using a short, anonymous, multiple‐choice questionnaire. Over three‐quarters of the sample admitted to a significant degree of dietary non‐compliance, especially those under the age of 60 years (p < 0.05). Although 96% of those on insulin or oral hypoglycaemics stated that they took medication exactly as prescribed, over half the sample admitted to being non‐compliant when performing home blood glucose monitoring. Almost a quarter of the sample said they had, at some time, fabricated results of blood or urine glucose testing, and eight subjects indicated that they had deliberately omitted to bring record books to clinic in the past. The vast majority (94%) of the diabetics said they would report diabetes‐related problems (such as hypoglycaemia) even if they had to be asked directly, but a small percentage would not report such problems at all. Almost all (96%) patients considered at least some of their fellow diabetics to be dishonest during an outpatient consultation, while only 25% thought that the clinic doctors believed everything their diabetic patients reported. These results suggest that, although compliance is poor, diabetic patients will usually admit to it in confidence. Thus, direct questioning remains a key tool in the management of diabetics of all ages. Copyright © 1988 John Wiley & Sons, Ltd.