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. 2020 Feb;33(1):50-57.
doi: 10.2337/ds19-0018.

Therapeutic Inertia: Still a Long Way to Go That Cannot Be Postponed

Manel Mata-Cases  1   2   3 , Josep Franch-Nadal  1   2   4 , Mònica Gratacòs  1 , Dídac Mauricio  1   2   5
Affiliations

Therapeutic Inertia: Still a Long Way to Go That Cannot Be Postponed

Manel Mata-Cases et al. Diabetes Spectr. 2020 Feb.

Abstract

In the context of type 2 diabetes, the definition of therapeutic inertia should include the failure not only to intensify therapy, but also to deintensify treatment when appropriate and should be distinguished from appropriate inaction in cases justified by particular circumstances. Therapy should be intensified when glycemic control deteriorates to prevent long periods of hyperglycemia, which increase the risk of complications. Strategic plans to overcome therapeutic inertia must include actions focused on patients, prescribers, health systems, and payers. Therapeutic inertia affects the management of glycemia, hypertension, and lipid disorders, all of which increase the risk for cardiovascular diseases. Thus, multifactorial interventions that act on additional therapeutic goals beyond glycemia are needed.

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Figures

FIGURE 1
FIGURE 1
Schematic of therapeutic inertia showing the proportion of patients above target receiving intensification within 12 months (in green); the median time to intensification from the time at which the A1C level is above the threshold (in red); and the glycemic burden (i.e., the length of time with A1C level above target [≥7, 7.5, or 8%]) during a given period of time (in blue) (29). *Estimated in patients with two OADs and three OADs after 14 months. **Estimated in patients with three OADs. GLP-1RA, glucagon-like peptide 1 receptor agonist.
See this image and copyright information in PMC

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