Related Experiment Video

Updated: May 26, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Association Between Therapeutic Inertia and Future Hypoglycemia Among Patients with Type 2 Diabetes

Helen Chen1,2,3,4, Lap Pui Chung5, Yutong Chen6

  • 1Division of Nursing Science, School of Nursing, Rutgers University, New Brunswick, NJ, USA.

Diabetes Epidemiology and Management
|May 25, 2026
PubMed
Abstract

Insights

Therapeutic inertia, failing to adjust diabetes treatment, increases hypoglycemia risk. Continuous glucose monitoring use did not significantly alter this association in the study.

Area of Science:

  • Endocrinology
  • Diabetes Management
  • Clinical Research

Background:

  • Therapeutic inertia (TI) hinders optimal glycemic control in type 2 diabetes (T2D).
  • Understanding factors associated with TI and its consequences is crucial for effective diabetes management.
  • The role of continuous glucose monitoring (CGM) in mitigating TI-related risks requires further investigation.

Purpose of the Study:

  • To examine the association between therapeutic inertia and subsequent hypoglycemia visits in adults with T2D.
  • To determine if continuous glucose monitoring (CGM) use modifies the relationship between therapeutic inertia and hypoglycemia risk.

Main Methods:

  • Analysis of electronic health records (2017-2023) from two US healthcare systems.
  • Inclusion criteria: adults with T2D, above-target HbA1c, and glucose-lowering prescriptions.
  • Logistic regression models assessed the association between high TI (>50%) and hypoglycemia visits, with interaction analysis for CGM use.

Main Results:

  • High therapeutic inertia was significantly associated with increased odds of hypoglycemia visits (OR=1.74).
  • Insulin users and Medicare beneficiaries exhibited higher odds of hypoglycemia visits.
  • Low continuous glucose monitoring (CGM) use (7%) limited the interpretation of its modifying effect on the TI-hypoglycemia association.

Conclusions:

  • High therapeutic inertia is a predictor of hypoglycemia visits in type 2 diabetes.
  • Further research is needed to identify TI drivers and optimize diabetes care to prevent hypoglycemia.
  • Balancing glycemic control improvement with hypoglycemia risk reduction remains a key challenge in T2D management.
Keywords:
HbA1cType 2 diabetescontinuous glucose monitoringprescriptionstherapeutic inertia

More Related Videos

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People12:59

Improving Strength, Power, Muscle Aerobic Capacity, and Glucose Tolerance through Short-term Progressive Strength Training Among Elderly People

Published on: July 5, 2017

Related Concept Videos

Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.
Type II Diabetes I: Introduction01:26

Type II Diabetes I: Introduction

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance, in which target tissues such as the liver, muscle, and adipose tissue respond poorly to insulin. It is also associated with inadequate compensatory insulin secretion, where pancreatic β-cells fail to produce sufficient insulin. Together, these abnormalities lead to persistent hyperglycemia.EtiologyT2DM develops through a complex interaction of genetic predisposition and environmental or...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Type I Diabetes II: Pathophysiology01:26

Type I Diabetes II: Pathophysiology

Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular uptake of...