Evidence map›Paper›PMID 42724543›Full record

ArticleEClinicalMedicine2026

The association of ADHD and ADHD medication with adherence to pharmacotherapy for type 2 diabetes: a population-based cohort study from seven countries.

Yiling Zhou, Honghui Yao, Tian Xie, Malcolm B Gillies, Yanli Zhang-James, Isabell Brikell, Anders Engeland, Le Gao, Birgitte Dige Semark, Theresa Wimberley and 15 more

Abstract read
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In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Yiling ZhouDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Honghui YaoDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Tian XieDepartment of Psychiatry, Interdisciplinary Center of Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Malcolm B GilliesSchool of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Yanli Zhang-JamesDepartment of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Isabell BrikellDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Anders EngelandDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Le GaoDepartment of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Birgitte Dige SemarkNational Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
Theresa WimberleyNational Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
Aske AstrupNational Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
Zihan DongDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Dina SarsembayevaDepartment of Psychiatry, Interdisciplinary Center of Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Melissa VosDepartment of Psychiatry, Interdisciplinary Center of Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Andrew S C YuenResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Søren DalsgaardNational Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
Stephen V FaraoneDepartment of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Kari KlungsøyrDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Henrik LarssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Kenneth K C ManResearch Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Ian C K WongCentre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Helga ZoegaCentre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Harold SniederDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Zheng ChangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Catharina A HartmanDepartment of Psychiatry, Interdisciplinary Center of Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) may compromise adherence to pharmacotherapy in adults with type 2 diabetes, but the relationship is unknown. We investigated the association of ADHD and ADHD medication with antidiabetic medication adherence in multinational cohort data. Methods: Using a common analytical protocol and population-based databases from seven countries, we identified adults initiating non-insulin antidiabetic medication between 2010 and 2020. ADHD was identified by diagnosis or ADHD medication use. We used the proportion of days covered (PDC) to measure antidiabetic medication adherence and defined the primary outcome, poor adherence, as PDC <80% over 1-, 2-, and 5-year follow-up periods. Time-to-first-discontinuation was the secondary outcome. Country-specific estimates were obtained using logistic and Cox regression and pooled using random-effects meta-analyses. Findings: Among 3,643,197 individuals included, 1,871,870 (51.4%) were female and 88,339 (2.4%) had ADHD (76,973 [87.1%] received ADHD medication). Overall, ADHD was not associated with poor adherence to antidiabetic medication (1-, 2-, and 5-year pooled odds ratios [OR]: 1.01 [95% CI 0.90-1.14], 1.03 [0.91-1.17], and 1.12 [0.95-1.31]); country-specific estimates ranged from 0.79 to 1.32, 0.80 to 1.35, and 0.80 to 1.47 at 1, 2, and 5 years, respectively. Among males, ADHD was associated with poorer adherence (1.09 [95% CI 1.00-1.20], 1.12 [1.00-1.24], and 1.23 [1.11-1.37] at 1, 2, and 5 years). Similar results were found for discontinuation. Among individuals with ADHD, ADHD medication use was consistently associated with better adherence over 1-, 2-, and 5-year follow-up periods (e.g., 5-year pooled OR 0.45 [0.30-0.67]); associations were directionally consistent across countries. Interpretation: Among adults with type 2 diabetes, ADHD may not necessarily compromise antidiabetic medication adherence when appropriately managed in routine care. ADHD pharmacological treatment may support adherence among adults with comorbid ADHD and type 2 diabetes, although its causal effect requires further evaluation. Funding: EU Horizon 2020 Research and Innovation Programme.

Indexed as

ADHDADHD medicationAntidiabetic medication adherenceMultinational cohort studyType 2 diabetes

Identifiers

PMID42724543
PMCPMC13559831

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.