New US research has found that as well as taking their medication, those with diabetes can also help control their blood sugar by managing their weight and exercising four or more times per week.
Carried out by the Kaiser Permanente Center for Health Research, the large-scale study looked at nearly 20,000 patients from Kaiser Permanente in Oregon and Southwest Washington.
Rather than ask participants to self-report on diabetes medication adherence, which can be unreliable, instead the researchers were able to use Kaiser Permanente's electronic health record system, which includes pharmacy refill data.
"Our physicians can look at a patient's electronic medical record and quickly see how often patients are refilling their diabetes, cholesterol and blood pressure medications. If patients are refilling medications when they're supposed to, they're also likely taking them when they're supposed to," explained lead author David Mosen,
"During office visits we also ask patients if they are exercising and then enter this information into their medical record."
The team also looked at several other lifestyle and demographic factors to see which were most closely associated with poorly controlled blood sugar.
From their data they found that participants who took their oral diabetes medications at least 80 percent of the time were 46 percent less likely to have poorly controlled blood sugar, compared to those who took their medications less than 80 percent of the time.
They also found that those who exercised four or more times a week were 25 percent less likely to have poorly controlled blood sugar than those who exercised three or fewer times per week.
As well as exercise, managing weight also had a positive effect on blood sugar, with those who were clinically obese -- with a body mass index (BMI) of 30 or more -- 18 percent more likely to have poorly controlled blood sugar, compared to those who were not obese.
Poorly controlled blood sugar can lead to other health conditions including kidney disease, retinal damage, heart disease, hospitalization and even death.
According to the American Diabetes Association (ADA) around 29 million Americans have diabetes, and the National Health and Nutrition Examination Survey notes that 21 percent of adults with diabetes have poorly controlled blood sugar.
"It's not that people are willfully not taking their medications, they just forget," said co-author Harry Glauber, "There's so much focus on new drugs and new technologies to improve diabetes care, but our study shows we could likely improve outcomes if we help patients do these three things: take their medications as prescribed, increase their exercise and manage their weight," he concluded.
The results can be found online published in the journal American Journal of Pharmacy Benefits.