Association of Unmet Social Needs With Metformin Use Among Patients With Type 2 Diabetes.



To evaluate the relationship between social needs and metformin use among adults with type 2 diabetes (T2D).

Research design and methods

In a prospective cohort study of adults with T2D (n = 722), we linked electronic health record (EHR) and Surescripts (Surescripts, LLC) prescription network data to abstract data on patient-reported social needs and to calculate metformin adherence based on expected refill frequency using a proportion of days covered methodology.


After adjusting for demographics and clinical complexity, two or more social needs (-0.046; 95% CI -0.089, 0.003), being uninsured (-0.052; 95% CI -0.095, -0.009) and while adjusting for other needs, being without housing (-0.069; 95% CI -0.121, -0.018) and lack of access to medicine/health care (-0.058; 95% CI -0.115, -0.000) were associated with lower use.


We found that overall social need burden and specific needs, particularly housing and health care access, were associated with clinically significant reductions in metformin adherence among patients with T2D.





Published Version (Please cite this version)


Publication Info

Drake, Connor, Jorge Morales Alfaro, Dan V Blalock, Kristin Ito, Bryan C Batch, Hayden B Bosworth, Seth A Berkowitz, Leah L Zullig, et al. (2023). Association of Unmet Social Needs With Metformin Use Among Patients With Type 2 Diabetes. Diabetes care, 46(11). pp. 2044–2049. 10.2337/dc23-0448 Retrieved from

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Daniel Blalock

Associate Consulting Professor in the Department of Psychiatry and Behavioral Sciences

I am a behavioral health researcher with a background in Clinical Psychology and Experimental Psychology.  My research interests include broad processes of behavior change and self-regulation as well as psychometric measurement and research methods/statistics.  My specific research endeavors include 1) the measurement and behavior change applicability of constructs related to self-control, 2) measurement and interventions to improve self-regulatory health behaviors including medication adherence and substance use, and 3) measure development and psychometrics as related to self-reported and patient-reported outcomes.


Bryan Courtney Batch

Professor of Medicine

Type 2 Diabetes, Obesity/Overweight, Behavior change, Non-pharmacologic intervention, Health disparities

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