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Clinical inertia is the enemy of therapeutic success in the management of diabetes and its complications: a narrative literature review
Open accessAbstract
Diabetes mellitus is a chronic disease characterized by high social, economic and health burden, mostly due to the high incidence and morbidity of diabetes complications. Numerous studies have shown that optimizing metabolic control may reduce the risk of micro and macrovascular complications related to the disease, and the algorithms suggest that an appropriate and timely step of care intensification should be proposed after 3 months from the failure to achieve metabolic goals. Nonetheless, many population studies show that glycemic control in diabetic patients is often inadequate. The phenomenon of clinical inertia in diabetology, defined as the failure to start a therapy or its intensification/de-intensification when appropriate, has been studied for almost 20 years, and it is not limited to diabetes care, but also affects other specialties. In the present manuscript, we have documented the issue of inertia in its complexity, assessing its dimensions, its epidemiological weight, and its burden over the effectiveness of care. Our main goal is the identification of the causes of clinical inertia in diabetology, and the quantification of its social and health-related consequences through the adoption of appropriate indicators, in an effort to advance possible solutions and proposals to fight and possibly overcome clinical inertia, thus improving health outcomes and quality of care.
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“At the patient level, concerns over drug side effects, misunderstanding the different treatment regimens, comorbidities, terminal illnesses, trypanophobia, a limited doctor–patient relationship, low education level, and socioeconomic status are major barriers for therapeutic intensification [10].”
From Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review (2023) · cites this paper as [10]
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“In terms of optimal management of diabetes, clinical inertia is a remarkable barrier to therapeutic success, because it delays the intensification of treatment [10].”
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“In about 30% of the individuals, IGT or impaired fasting glucose (IFG) progresses to diabetes.”
From Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review (2023) · cites this paper as [10]
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“In terms of optimal management of diabetes, clinical inertia is a remarkable barrier to therapeutic success, because it delays the intensification of treatment [10].”
BackgroundInfluentialBain, S. C., Bekker Hansen, B., Hunt, B., Chubb, B., & Valentine, W. J. (2020) · Journal of Medical Economics · doi:10.1080/13696998.2019.1645018 · Cited by 53
Metadata
- Authors
- Andreozzi, F., Candido, R., Corrao, S., Fornengo, R., Giancaterini, A., Ponzani, P., Ponziani, M. C., Tuccinardi, F., & Mannino, D.
- Affiliations
- Magna Graecia University (IT)
- Azienda Sanitaria Universitaria Integrata di Trieste (IT)
- University of Palermo (IT)
- Azienda ospedaliera "Bianchi-Melacrino-Morelli" (IT)
- Corresponding author
- Andreozzi, F.
- Venue
- Diabetology & Metabolic Syndrome
- Published
- 2020-06-17
- Volume
- 12
- Issue
- 1
- Pages
- 52-52
- ISSN
- 1758-5996 (ISSN-L)
- PMC
- PMC7301473
- OpenAlex
- W3036158386
- Cited by
- 128
- References
- 89
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 27 · 2023: 25 · 2022: 22 · 2021: 23 · 2020: 2
- FWCI
- 2.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Diabetology & Metabolic Syndrome (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- Funders
- MSD Italia
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- clinical inertia, diabetes mellitus, glycemic control, diabetes complications, microvascular complications, macrovascular complications, treatment intensification, quality of care, health outcomes
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