Peer Reviewed
Feature Article Endocrinology and metabolism

Diabetes care: therapeutic inertia in doctors and patients

Pat Phillips
Abstract
One of the major barriers to best practice diabetes care is therapeutic inertia – failure to increase therapy when goals are unmet. An ‘active’ approach to routine diabetes care can greatly help in the control of complication risk factors and diabetic complications.
Key Points
  • Therapeutic inertia – the failure to increase therapy when goals are unmet – is a major barrier to best practice diabetes care and treating to target in patients with type 2 diabetes.
  • Most patients with type 2 diabetes are not achieving the targets of diabetes management (the ABCss – controlling glycosylated haemoglobin, blood pressure and cholesterol levels [ABC], quitting smoking [s] and taking salicylates [s]). Moving closer on all these targets has a dramatic therapeutic effect.
  • Doctors should be active and insistent about achieving and maintaining target values of the main risk factors of diabetic complications, detecting problems early and intervening promptly.
  • Patients should be informed about their diabetes and the required self-care and medical care, including adopting a healthy lifestyle, practising preventive care and, like doctors, being active and insistent about achieving and maintaining target values.
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