Clinical inertia in the management of type 2 diabetes mellitus: A focused literature review

Abstract

Achieving tight glycaemic control early on in the disease trajectory has been shown to have beneficial effects on macrovascular and microvascular complications and mortality in people with type 2 diabetes. International guidelines recommend individualised targets for glycaemic control, but many people with type 2 diabetes are not adequately reaching these targets. One major reason for not achieving these targets is 'clinical inertia', defined as 'failure of healthcare providers to initiate or intensify therapy when indicated'. This article gives an overview of clinical inertia in the management of type 2 diabetes, relating to the initiation of oral antidiabetic and insulin therapies, reasons for clinical inertia and strategies for overcoming clinical inertia.