{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T19:26:31Z","timestamp":1790018791769,"version":"4.0.1"},"reference-count":47,"publisher":"American Diabetes Association","issue":"11","license":[{"start":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T00:00:00Z","timestamp":1476921600000},"content-version":"vor","delay-in-days":114,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health","award":["U01-DK-61212"],"award-info":[{"award-number":["U01-DK-61212"]}]},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health","award":["U01-DK-61230"],"award-info":[{"award-number":["U01-DK-61230"]}]},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health","award":["U01-DK-61239"],"award-info":[{"award-number":["U01-DK-61239"]}]},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health","award":["U01-DK-61242"],"award-info":[{"award-number":["U01-DK-61242"]}]},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health","award":["U01-DK-61254"],"award-info":[{"award-number":["U01-DK-61254"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To identify factors that predict medication adherence and to examine relationships among adherence, glycemic control, and indices of insulin action in TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A total of 699 youth 10\u201317 years old with recent-onset type 2 diabetes and \u226580% adherence to metformin therapy for \u22658 weeks during a run-in period were randomized to receive one of three treatments. Participants took two study pills twice daily. Adherence was calculated by pill count from blister packs returned at visits. High adherence was defined as taking \u226580% of medication; low adherence was defined as taking &amp;lt;80% of medication. Depressive symptoms, insulin sensitivity (1\/fasting insulin), insulinogenic index, and oral disposition index (oDI) were measured. Survival analysis examined the relationship between medication adherence and loss of glycemic control. Generalized linear mixed models analyzed trends in adherence over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In this low socioeconomic cohort, high and low adherence did not differ by sex, age, family income, parental education, or treatment group. Adherence declined over time (72% high adherence at 2 months, 56% adherence at 48 months, P &amp;lt; 0.0001). A greater percentage of participants with low adherence had clinically significant depressive symptoms at baseline (18% vs. 12%, P = 0.0415). No adherence threshold predicted the loss of glycemic control. Longitudinally, participants with high adherence had significantly greater insulin sensitivity and oDI than those with low adherence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In the cohort, the presence of baseline clinically significant depressive symptoms was associated with subsequent lower adherence. Medication adherence was positively associated with insulin sensitivity and oDI, but, because of disease progression, adherence did not predict long-term treatment success.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc15-2296","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T03:18:41Z","timestamp":1467170321000},"page":"1956-1962","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":69,"title":["Correlates of Medication Adherence in the TODAY Cohort of Youth With Type 2 Diabetes"],"prefix":"10.2337","volume":"39","clinical-trial-number":[{"clinical-trial-number":"nct00081328","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Lorraine Levitt","family":"Katz","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX"},{"name":"Texas Children\u2019s Hospital, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siripoom V.","family":"McKay","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"State University of New York Upstate Medical University, Syracuse, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri L.","family":"Casey","sequence":"additional","affiliation":[{"name":"University Hospitals Case Medical Center, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie A.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"Wauters","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center, San Antonio, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Hirst","sequence":"additional","affiliation":[{"name":"George Washington University Biostatistics Center, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen J.","family":"Nadeau","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the TODAY Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,6,28]]},"reference":[{"key":"2022031301100443100_B1","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.2337\/dc13-0743","article-title":"Crisis in care: limited treatment options for type 2 diabetes in adolescents and youth","volume":"36","author":"Tamborlane","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031301100443100_B2","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1056\/NEJMoa1109333","article-title":"A clinical trial to maintain glycemic control in youth with type 2 diabetes","volume":"366","author":"Zeitler","year":"2012","journal-title":"N Engl J Med"},{"key":"2022031301100443100_B3","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.2337\/dc06-0454","article-title":"Adherence to preventive medications: predictors and outcomes in the Diabetes Prevention Program","volume":"29","author":"Walker","year":"2006","journal-title":"Diabetes Care"},{"key":"2022031301100443100_B4","volume-title":"Adherence to Pediatric Medical Regimens","author":"Rapoff","year":"1999"},{"key":"2022031301100443100_B5","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.2337\/diacare.20.10.1569","article-title":"Disparity in glycemic control and adherence between African-American and Caucasian youths with diabetes. 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