Poor disease control has been found to be associated with microvascular complications and mortality. Current recommendations for glycemic control targets, as assessed by HbA1c levels, are dependent on age and duration of illness. Nevertheless, HbA1c levels greater than 75mmol/mol are universally considered poor control. Despite evidence of the efficacy of hypoglycemic medications to help diabetes patients regulate and control their glucose levels, great variation in adherence to these medications has been reported, with studies often indicating poor or low average levels of adherence. Consequently, the clinical focus of therapeutic interventions for improving glycemic control is often on oral Isoliquiritin medication adherence, and, at later disease stages, on adherence with recommended parenteral insulin treatment. A substantial body of literature has demonstrated a positive association between medication adherence and glucose control ; however, the methodologies of these studies have weaknesses that include small sample sizes, selective populations, and subjective patient reported measures�Cwhich potentially limit statistical significance and generalizability of results. Previous studies have found that the young diabetes population and individuals with long-term diabetes are at an increased risk for poor control ; however, the factors contributing to this relationship are not well Digoxin understood. Of those diabetes patients with longer duration of illness, many are taking multiple diabetes medications that are being actively managed by the patients or by their physicians. Multiple drug regimens pose a challenge to measuring medication adherence because of the potential for missing changes in the prescribed treatment regimen. While the younger adult and long disease duration sub-groups have been identified as key population segments at-risk for poor glycemic control, the evidence of the extent to which medication adherence contributes to this poor control is still lacking. The present study aimed to retrospectively assess the importance of adherence to multiple diabetes medications in a large, general population of individuals with diabetes using an objective medication adherence measure that accounts for these multi-drug regimens.