Therapeutic inertia in type 2 diabetes: prevalence, causes, consequences and methods to overcome inertia

Area of Science:

• Endocrinology
• Metabolic Diseases
• Clinical Medicine

Background:

• Effective glycemic control in type 2 diabetes mellitus (T2DM) is essential for mitigating long-term macrovascular and microvascular complications.
• Despite robust evidence supporting early and intensive glycemic management, global control remains suboptimal.
• Therapeutic inertia, characterized by delays in escalating treatment, is a significant barrier across all stages of T2DM management, from oral antihyperglycaemic drugs (OADs) to insulin initiation.

Purpose of the Study:

• To comprehensively review the causes, consequences, and potential solutions for therapeutic inertia in type 2 diabetes.
• To analyze therapeutic inertia from the perspectives of healthcare professionals (HCPs), patients, and healthcare systems.
• To synthesize existing literature to provide a deeper understanding of this clinical challenge.

Main Methods:

• Systematic literature review of published evidence on therapeutic inertia in type 2 diabetes.
• Analysis of factors contributing to therapeutic inertia at provider, patient, and system levels.
• Synthesis of evidence-based strategies to overcome therapeutic inertia.

Main Results:

• Therapeutic inertia is a pervasive issue, delaying necessary treatment intensification for patients with type 2 diabetes.
• Contributing factors include provider-related issues, patient-related barriers, and systemic healthcare challenges.
• Addressing therapeutic inertia requires multifaceted interventions targeting all stakeholders.

Conclusions:

• Overcoming therapeutic inertia is critical for improving glycemic control and reducing diabetes-related complications.
• A collaborative approach involving HCPs, patients, and healthcare systems is necessary for effective management.
• Further research and implementation strategies are needed to address this global challenge in type 2 diabetes care.