The Relationship Between Disease Awareness and Treatment Adherence in Patients with Diabetes: A Single-Center Study
Abstract
Objective: Diabetes mellitus is a chronic metabolic disease requiring long-term lifestyle modification and medical treatment. Inadequate disease management may lead to serious acute and chronic complications, increased morbidity, and reduced quality of life. Treatment adherence in diabetes is a multifactorial process influenced by pharmacological regimens, disease awareness, education level, and sociodemographic characteristics. Previous studies have shown that insufficient knowledge about the disease and low awareness are associated with poor glycemic control and accelerated disease progression. Given the lifelong nature of diabetes treatment, difficulties in disease acceptance and sustaining treatment adherence are common. Understanding how patients’ awareness, education, and self-perceived knowledge relate to treatment adherence and laboratory outcomes may explain poor glycemic control. Therefore, this study aimed to evaluate the relationship between treatment adherence, disease awareness, and disease progression by analyzing questionnaire data and laboratory findings of patients admitted to Recep Tayyip Erdoğan University Training and Research Hospital. Methods: This study was conducted using a questionnaire-based survey administered to 500 patients diagnosed with type 2 diabetes mellitus for at least three months who attended Recep Tayyip Erdoğan University Training and Research Hospital. Results: Of the 500 diabetic patients included in the study, 284 (56.8%) were female and 216 (43.2%) were male. The mean age of the participants was 59.7 ± 13.1 years. The mean HbA1c level was 7.7 ±1.59, while the mean Morisky adherence score was 5.4 ± 1.7. Low adherence was observed in 259 patients (51.8%), moderate adherence in 172 patients (34.4%), and high adherence in 69 patients (13.8%). A statistically significant difference was found between Morisky adherence categories and HbA1c levels (p < 0.001). HbA1c levels were highest among patients with low adherence and lowest among those with high adherence. Conclusion: HbA1c levels were significantly higher in patients with low Morisky adherence scores, whereas the lowest HbA1c levels were observed in patients with high adherence. Additionally, the proportion of patients with high adherence was significantly greater among those receiving oral antidiabetic therapy alone compared to those receiving combined insulin and oral antidiabetic treatment.
Ethical Statement
This study was approved by the Institutional Ethics Committee of RECEP TAYYİP ERDOĞAN UNIVERSITY Hospital (Approval No: 2023/163). Written informed consent was obtained from all participants. The authors declare no conflict of interest.
Thanks
Assoc. Prof. Dr. Hatice Beyazal Polat is gratefully acknowledged for her valuable contributions and guidance during the preparation of this study.
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Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Research Article |
| Authors | |
| Submission Date | January 18, 2026 |
| Acceptance Date | February 12, 2026 |
| Publication Date | March 10, 2026 |
| DOI | https://doi.org/10.46310/tjim.1866507 |
| IZ | https://izlik.org/JA52WF74WM |
| Published in Issue | Year 2026 Volume: 8 |
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Conceptualization: FA, SA;
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Author(s) and editor(s)
- Aristotle. Nicomachean ethics. Crisp R, editor. Cambridge (UK): Cambridge University Press; 2000.
- Kant I. Critique of pure reason. Guyer P, Wood AW, editors. New York (NY): Cambridge University Press; 1998.
Organization(s) as author
- World Health Organization. World malaria report 2023. Geneva: World Health Organization; 2023. 283 p.
Editor(s), compiler(s) as author
- Firth JD, Conlon C, Cox TM, editors. Oxford textbook of medicine. 6th ed. Oxford (UK): Oxford University Press; 2020.
- Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 9th ed. Philadelphia (PA): Elsevier; 2020
Translated book
- Foucault M. Discipline and punish: the birth of the prison. Sheridan A, translator. New York (NY): Vintage Books; 1995.
- Homer. The iliad. Fagles R, translator. New York (NY): Penguin Classics; 1998.
Chapter in a book
- Clasen T. Water and sanitation. In: Detels R, Gulliford M, Abdool Karim QA, Tan CC, editors. Oxford textbook of global public health. 6th ed. Oxford (UK): Oxford University Press; 2015. p. 162-79. doi:10.1093/med/9780199661756.003.0011.
- Williams GM. Statistical methods. In: Detels R, Beaglehole R, Lansang MA, Gulliford M, editors. Oxford textbook of public health. 5th ed. Oxford (UK): Oxford University Press; 2009. p. 677-715.
Conference proceedings
- Youn HY, Cho WD, editors. UbiComp 2008: ubiquitous computing, 10th International Conference, UbiComp 2008; 2008 Sep 21–24; Seoul, Korea. New York (NY): ACM; 2008.
- Halliday RB, Walter DE, Proctor HC, Norton RA, Colloff MJ, editors. Acarology: Proceedings of the 10th International Congress; 1998 Jul 5–10; Canberra, Australia. Melbourne: CSIRO Publishing; 2001.
Dissertation (Thesis)
- Davis FD. A technology acceptance model for empirically testing new end-user information systems: theory and results [dissertation]. Cambridge (MA): Massachusetts Institute of Technology (Sloan School of Management); 1986.
- Sürer S. From space to safety: flood mapping with Sentinel-1 SAR data for enhancing flood risk management in Ljungby Municipality [master’s thesis]. Lund (SE): Lund University; 2024 [Internet]. [cited 2025 Nov 22]. Available from: https://lup.lub.lu.se/student-papers/record/9158441
- Patwary MM. Adoption of mobile banking applications: a study on young people [master’s thesis]. Eskişehir (TR): Anadolu University Graduate School of Social Sciences; 2017 [Internet]. [cited 2025 Nov 22]. Available from: https://doi.org/10.13140/RG.2.2.35579.49446
Poster(s)
- Ashby S, Bowman CR, Zeithamova D. Generalized memory representations emerge across paired-associate training [poster]. Presented at: Neuroscience 2019 (49th Annual Meeting of the Society for Neuroscience); 2019 Oct 19–23; Chicago, IL.
- Foushee R, Srinivasan M, Xu F. The impact of speech complexity on preschooler attention and learning [poster]. Presented at: 45th Boston University Conference on Language Development (BUCLD 45); 2020 Nov 5–8; Boston, MA, USA (virtual).
Patent
- Duong-Van Minh, inventor; Interos Inc, assignee. Sentiment analysis from social media content. United States patent US 8,849,826. 2014 Sep 30.
Homepage/Website
- Eurostat [Internet]. Luxembourg (LU): Statistical Office of the European Union; c1953– [cited 2025 Sep 27]. Available from: https://ec.europa.eu/eurostat
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Ethical Principles and Publication Policy
Section A: Publication and authorship
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Section B: Authors’ responsibilities
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Section C: Peer review/responsibility for the reviewers
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4. Reviewers may identify relevant published work that has not been cited by the authors.
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Section D: Editorial responsibilities
1. Editors (Associate Editors or Editor in Chief) have complete responsibility and authority to reject/accept an article.
2. Editors are responsible for the contents and overall quality of the publication.
3. Editors should always consider the needs of the authors and the readers when attempting to improve the publication.
4. Editors should guarantee the quality of the papers and the integrity of the academic record.
5. Editors should publish errata pages or make corrections when needed.
6. Editors should have a clear picture of research funding sources.
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8. Editors should not reverse their decisions nor overturn the ones of previous editors without serious reason.
9. Editors should preserve the anonymity of reviewers (in half blind peer review journals).
10. Editors should ensure that all research material they publish conforms to international accepted ethical guidelines.
11. Editors should only accept a paper when reasonably certain.
12. Editors should act if they suspect misconduct, whether a paper is published or unpublished, and make all reasonable attempts to persist in obtaining a resolution to the problem.
13. Editors should not reject papers based on suspicions; they should have proof of misconduct.
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15. Editors must not change their decision after submitting a decision (especially after reject or accept) unless they have a serious reason.
Section E: Publishing Ethics Issues
Editorial Board of the Turkish Journal of Internal Medicine complies with the criteria of the International Council of Medical Journal Editors (ICMJE), the World Association of Medical Editors (WAME), and Committee on Publication Ethics (COPE).
1. All editorial members, reviewers, and authors must confirm and obey rules defined by COPE.
2. The corresponding author is the main owner of the article so she/he can withdraw the article when it is incomplete (before entering the review process or when a revision is asked for).
3. Authors cannot make major changes in the article after acceptance without a serious reason.
4. All editorial members and authors must will to publish any kind of corrections honestly and completely.
5. Any notes of plagiarism, fraudulent data, or any other kinds of fraud must be reported completely to COPE.
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