Comparison of Therapeutic Inertia in Type 2 Diabetes Mellitus between Primary Care Physicians and Endocrinologists

Abstract

Good early glycemic control leads to clinical improvements, including a reduction in long-term micro and macrovascular complications. However, there has been no improvement in the achievement of glycated hemoglobin A targets in the last decade globally. One causal factor is therapeutic inertia, defined as delay in starting or intensifying therapy when glycemic treatment targets have not been met. The objective was to compare therapeutic inertia in diabetes mellitus type 2 between primary care physicians and endocrinologists, as well as to identify opportunities to strengthen diabetes care in primary care. Data search in PubMed from 2011 to December 2021. Late intensification of treatment is not observed exclusively in primary care, but also in the field of diabetes specialists. The causes of therapeutic inertia are complex, encompassing both reasonable and unacceptable delays on the part of the physician and poor adherence to treatment by the patient. New educational strategies are needed to help physicians timely intensify treatment when glycemic targets are not met to prevent disease progression.