Clinical inertia causing new or progression of diabetic retinopathy in type 2 diabetes: A retrospective cohort study

Osataphan, Soravis; Chalermchai, Thep; Ngaosuwan, Kanchana

doi:10.1111/1753-0407.12410

Cited by 40 publications

(53 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Out of 7698 combined search results, 53 articles were identified that reported at least 1 measure of therapeutic inertia in the management of hyperglycaemia in individuals with type 2 diabetes . The main reasons for exclusion of publications other than duplicates and those covering irrelevant topics were that they reported non‐original research (eg, editorials, letters, comments and guidelines) or they were congress abstracts (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies were conducted in North America (29 studies) and Europe (20 studies). Three studies were carried out in Asia, and a single study was conducted in Israel . Articles mainly reported data from cohort studies, using data from medical records or chart reviews, or from claims, clinical research or administrative databases.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were carried out in Asia, and a single study was conducted in Israel . Articles mainly reported data from cohort studies, using data from medical records or chart reviews, or from claims, clinical research or administrative databases. Four articles reported results from cross‐sectional studies, and the data were collected using provider questionnaires or surveys .…”

Section: Resultsmentioning

confidence: 99%

“…Patients were managed by primary care providers in 21 studies, by both primary care providers and secondary care specialists in 6 studies, and by secondary care specialists alone in 1 study . The healthcare providers responsible for patient care were not described in 25 studies .…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review

Khunti

Gomes

Pocock

et al. 2017

Diabetes Obesity Metabolism

284

264

View full text Add to dashboard Cite

AimsTherapeutic inertia, defined as the failure to initiate or intensify therapy in a timely manner according to evidence‐based clinical guidelines, is a key reason for uncontrolled hyperglycaemia in patients with type 2 diabetes. The aims of this systematic review were to identify how therapeutic inertia in the management of hyperglycaemia was measured and to assess its extent over the past decade.Materials and MethodsSystematic searches for articles published from January 1, 2004 to August 1, 2016 were conducted in MEDLINE and Embase. Two researchers independently screened all of the titles and abstracts, and the full texts of publications deemed relevant. Data were extracted by a single researcher using a standardized data extraction form.ResultsThe final selection for the review included 53 articles. Measurements used to assess therapeutic inertia varied across studies, making comparisons difficult. Data from low‐ to middle‐income countries were scarce. In most studies, the median time to treatment intensification after a glycated haemoglobin (HbA1c) measurement above target was more than 1 year (range 0.3 to >7.2 years). Therapeutic inertia increased as the number of antidiabetic drugs rose and decreased with increasing HbA1c levels. Data were mainly available from Western countries. Diversity of inertia measures precluded meta‐analysis.ConclusionsTherapeutic inertia in the management of hyperglycaemia in patients with type 2 diabetes is a major concern. This is well documented in Western countries, but corresponding data are urgently needed in low‐ and middle‐income countries, in view of their high prevalence of type 2 diabetes.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review

Khunti

Gomes

Pocock

et al. 2017

Diabetes Obesity Metabolism

284

264

View full text Add to dashboard Cite

show abstract

“…In a UK study of patients treated with basal insulin who were clinically eligible for treatment intensification, only 31% had their treatment intensified, with a median time to intensification of 3.7 years . Delay in treatment intensification in patients with uncontrolled T2D has been shown to have a number of clinical consequences, including a significantly increased risk of myocardial infarction, heart failure, stroke, and a composite endpoint of cardiovascular events, as well as a higher incidence of (and significantly shorter median time to) progression of diabetic retinopathy . This progression of diabetes‐related complications with lack of treatment intensification in the overall T2D population is also seen in older adults …”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of lixisenatide as add‐on therapy to basal insulin in older adults with type 2 diabetes in the GetGoal‐O Study

Dailey

Dex

Roberts

et al. 2019

Journal of Diabetes

View full text Add to dashboard Cite

Background This study compared the efficacy and safety of lixisenatide with placebo as add‐on therapy to basal insulin (BI) in adults aged ≥70 years with type 2 diabetes (T2D), with or without moderate renal insufficiency. Methods This post hoc analysis evaluated data from non‐frail patients with T2D inadequately controlled on BI with or without oral antidiabetic drugs (n = 108), randomized to once‐daily lixisenatide 20 μg or placebo for 24 weeks (GetGoal‐O Study). The primary endpoint was the change in HbA1c from baseline to Week 24. Secondary endpoints included changes from baseline in fasting plasma glucose, 2‐hour postprandial plasma glucose (PPG), average seven‐point self‐monitored plasma glucose (SMPG), area under the curve for SMPG, daily BI dose, body weight, proportion of patients achieving HbA1c > 0.5%, and composite endpoints. Safety outcomes included the incidence of documented symptomatic hypoglycemia (plasma glucose <60 mg/dL) and gastrointestinal treatment‐emergent adverse events (TEAEs). Outcomes were also analyzed by the occurrence of moderate renal insufficiency. Results Compared with placebo, lixisenatide‐treated patients had significantly greater reductions in HbA1c, 2‐hour PPG, average seven‐point SMPG, and body weight. Documented symptomatic hypoglycemia was approximately two‐fold higher in patients treated with placebo than lixisenatide (12.7% vs 5.7%). GI TEAEs occurred more frequently in the lixisenatide‐ than placebo‐treated group (34% vs 9.1%). Moderate renal insufficiency (estimated glomerular filtration rate between ≥30 and <60 mL/min/1.73 m2) did not negatively affect lixisenatide efficacy or safety. A greater proportion of patients treated with lixisenatide than placebo achieved composite endpoints. Conclusions Add‐on therapy with lixisenatide in non‐frail patients aged ≥70 years with T2D uncontrolled with BI is effective, safe, and well tolerated and should be considered in this population.

show abstract

Clinical Inertia: The Role of Physicians in Diabetes Outcomes

Rodriguez-Saldana¹

2019

The Diabetes Textbook

View full text Add to dashboard Cite

Clinical inertia causing new or progression of diabetic retinopathy in type 2 diabetes: A retrospective cohort study

Abstract: Clinical inertia can cause persistently poor glycemic control and speed up the progression of DR in T2D.

Cited by 40 publications

References 17 publications

Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review

Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review

Efficacy and safety of lixisenatide as add‐on therapy to basal insulin in older adults with type 2 diabetes in the GetGoal‐O Study

Clinical Inertia: The Role of Physicians in Diabetes Outcomes

Contact Info

Product

Resources

About