Changes of carbohydrate metabolism and insulin resistance parameters at different compliance levels in young people

Abstract

Aim. To analyze early disorders of carbohydrate metabolism and insulin resistance (IR) at different compliance levels in young people.Material and methods. Ninety-four patients (45 men/49 women; median (Me)=33 [28,7-38] years) were examined. This prospective observational study used data of the questionnaire of the quantitative assessment of the adherence to treatment (QAA-25), fasting plas­ma glucose levels, oral glucose tolerance test, levels of glycated hemo­globin (HbA1c), insulin and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Statistical processing was carried out in IBM SPSS Statistics 26.Results. Only 15,8% had high adherence to medical support, 8,9% — lifestyle modification (LM) and general compliance, 10,9% — drug therapy. The means for most types of adherences were in the low range. In the low and medium LM groups, over 18 months the number of patients with elevated HbA1c levels increased from 7,1 to 18,8% (p=0,021) and IR from 12% to 31,8% (p=0,000). In patients with low overall LM compared to high ones, the probability of HbA1c increase raised by 5,5 times, and hyperinsulinemia by 1,16 times.Conclusion. In an 18-month prospective study, young adults with low compliance levels showed an increase in the incidence of hyper­insulinemia, IR, and prediabetes.

Keywords

• adherence
• qaa-25
• prediabetes
• insulin resistance