Diabetes is a public health epidemic affecting ∼34 million Americans with type 2 diabetes (1). American Indians are nearly three times more likely to be diagnosed with type 2 diabetes than non-Hispanic Whites (2) and more than twice as likely to die of complications of type 2 diabetes (3).

Medications are often a necessary strategy for managing type 2 diabetes. Medication adherence is linked with better glycemic control, fewer hospitalizations, and decreased medical costs (4,5). Factors and sociodemographic variables that affect medication adherence have been explored extensively in the literature, including the cost of medications, skepticism about medications, regimen complexity, depression, age, and forgetfulness in both taking and refilling medications (5).

In a recent study, the medication adherence rate was found to be higher in Whites (76.9%) compared with Hispanics (68.5%), Blacks (69.4%), and Asians (74.3%), but American...

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