Adherence to Insulin Treatment in People With Type 1 or Type 2 Diabetes in Primary Health Care in a Brazilian City: A Cross‐Sectional Study

ABSTRACT Background and Aim Non‐adherence to diabetes medication treatment is a recognized public health problem that can lead to unfavorable clinical, humanistic, and economic outcomes. This study aimed to analyze adherence to insulin treatment in people with type 1 diabetes or type 2 diabetes in primary health care in a Brazilian municipality. Methods This cross‐sectional study was developed with 152 participants and a simple probability sample. We collected blood and urine samples, performed ophthalmological fundus examinations using a portable retinal camera on a smartphone, and conducted face‐to‐face interviews. Adherence was measured using the Insulin Treatment Adherence Measure, a version validated in Brazil. Results A higher proportion of women (63.2%), without private health plan (84.2%), with a medically diagnosed type 2 diabetes (93.3%), inadequate glycemic control (76.9%), and without diabetic retinopathy (71.7%) was observed. The prevalence of insulin therapy adherence was estimated at 47.4% (95% CI 39.4–55.3). Higher insulin therapy adherence was observed among males, self‐reported Nonwhite race/ethnicity, and those diagnosed with systemic arterial hypertension. A negative association was observed with alcohol abuse, amputation, and among those with private health plan (p < 0.05). Conclusion Adherence to insulin treatment was low, and this scenario can lead to complications with various impacts, including increased healthcare costs. The associated variables evidenced the need for drug therapy management, incorporating multidimensional care for people with diabetes, to enable disease control in primary health care.