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. 2024 Feb 15;16(1):42.
doi: 10.1186/s13098-023-01245-0.

Clinical inertia in newly diagnosed type 2 diabetes mellitus among patients attending selected healthcare institutions in Colombia

Nelson Alvis-Guzman  1   2 , Martín Romero  3 , Fernando Salcedo-Mejia  4 , Maria Carrasquilla-Sotomayor  4   5 , Lina Gómez  3 , Mónica María Rojas  6 , Juan Camilo Urrego  6 , Claudia Catalina Beltrán  6 , Jaime Enrique Ruíz  6 , Adriana Velásquez  6 , Juan Carlos Orengo  7 , Adolfo Pinzón  8
Affiliations

Clinical inertia in newly diagnosed type 2 diabetes mellitus among patients attending selected healthcare institutions in Colombia

Nelson Alvis-Guzman et al. Diabetol Metab Syndr. .

Erratum in

Abstract

Background: The burden of disease of diabetes in Colombia have increased in the last decades. Secondary prevention is crucial for diabetes control. Many patients already treated remain with poor glycemic control and without timely and appropriate treatment intensification. This has been called in the literature as Clinical Inertia. Updated information regarding clinical inertia based on the Colombian diabetes treatment guidelines is needed.

Objective: To measure the prevalence of clinical inertia in newly diagnosed Type 2 Diabetes Mellitus (T2DM) patients in healthcare institutions in Colombia, based on the recommendations of the current official guidelines.

Methods: An observational and retrospective cohort study based on databases of two Health Medical Organizations (HMOs) in Colombia (one from subsidized regimen and one from contributory regimen) was conducted. Descriptive analysis was performed to summarize demographic and clinical information. Chi-square tests were used to assess associations between variables of interest.

Results: A total of 616 patients with T2DM (308 for each regimen) were included. Median age was 61 years. Overall clinical inertia was 93.5% (87.0% in contributory regimen and 100% in subsidized regimen). Patients with Hb1Ac ≥ 8% in the subsidized regimen were more likely to receive monotherapy than patients in the contributory regimen (OR 2.33; 95% CI 1.41-3.86).

Conclusions: In this study, the prevalence of overall clinical inertia was higher in the subsidized regime than in the contributory regime (100% vs 87%). Great efforts have been made to equalize the coverage between the two systems, but this finding is worrisome with respect to the difference in quality of the health care provided to these two populations. This information may help payers and clinicians to streamline strategies for reducing clinical inertia and improve patient outcomes.

Keywords: Adult; Clinical inertia; Glycaemic control; Type 2 diabetes mellitus.

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Conflict of interest statement

Mónica María Rojas, Juan Camilo Urrego, Claudia Catalina Beltrán, Jaime Enrique Ruíz, Adriana Velásquez, Juan Carlos Orengo and Adolfo Pinzón are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ USA, who may own stock and/or hold stock options in Merck & Co., Inc., Rahway, NJ, USA. Nelson Alvis, Fernando Salcedo, and Maria Carrasquilla from Grupo ALZAK received financial support from MSD. Martin Romero and Lina Gómez from Grupo Proyectame also received financial support from MSD.

Figures

Fig. 1
Fig. 1
Algorithm of initial pharmacological approach based on HbA1c cut-off points. Adapted from Colombian diabetes guideline
See this image and copyright information in PMC

References

    1. Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, et al. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet. 2023;402(10397):203–234. doi: 10.1016/S0140-6736(23)01301-6. - DOI - PMC - PubMed
    1. IDF Diabetes Atlas . IDF Diabetes Atlas 2022 Reports. Leuven: IDF Diabetes Atlas; 2022.
    1. Cuenta de Alto Costo . Situación de la enfermedad renal crónica, la hipertensión arterial y la diabetes mellitus en Colombia. Bogotá: Cuenta de Alto Costo; 2021.
    1. Aschner P, King H, Triana de Torrado M, Rodriguez BM. Glucose intolerance in Colombia. A population-based survey in an urban community. Diabetes Care. 1993;16(1):90–93. doi: 10.2337/diacare.16.1.90. - DOI - PubMed
    1. Escobedo J, Buitrón LV, Velasco MF, Ramírez JC, Hernández R, Macchia A, et al. High prevalence of diabetes and impaired fasting glucose in urban Latin America: the CARMELA study. Diabet Med. 2009;26(9):864–871. doi: 10.1111/j.1464-5491.2009.02795.x. - DOI - PubMed

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