Compliance with chronic disease regimens: diabetes

Patient compliance with the prescribed management regimen is presented as the fourth component responsible for control of blood sugar in insulin-taking diabetics, along with insulin dose, food consumed, and exercise performed. Noncompliance is ascribed to a large variety of reasons which vary in importance from diabetic to diabetic. A survey of ten diabetic women, two of whom were uremic and eight of whom were renal transplant recipients, was conducted to assess their compliance with advised shoe prescriptions. Observed compliance with wearing acceptable shoes is delineated as occurring because it fits with patients' life-styles. It was found that three of ten women refused to wear recommended footgear all of the time, whereas one woman varied her acceptance of advised shoes. Contracts between patients and health care team members are offered as a means of encouraging compliance; individualizing the health team's care of the patient is put forward as the most significant approach.