ArticleDiabetes spectrum : a publication of the American Diabetes Association2023
Therapeutic Inertia and Delays in Insulin Intensification in Type 2 Diabetes: A Literature Review.
Article in Diabetes spectrum : a publication of the American Diabetes Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed.
- The Effect of Intrinsic Factors on the Pharmacokinetics of Once-Weekly Insulin Icodec in Type 1 and Type 2 Diabetes: A Population Pharmacokinetic Analysis of Phase II and Phase III trials.Clinical pharmacokinetics · 2026Article
- Article
- Primary Care-Initiated Continuous Glucose Monitoring in Adults With Insulin-Treated Diabetes.JAMA network open · 2026Article
- Exploring insulin rejection through photo-elicitation among informal caregivers and patients with type 2 diabetes mellitus.Korean journal of family medicine · 2026Article
- Efficacy and Safety of Insulin Efsitora Versus Degludec in Adults with Type 2 Diabetes Who Are Insulin-Naïve: Japan Subgroup Analysis of QWINT-2.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026Article
- Once-weekly administration of insulin in the real-world management of type 2 diabetes. A Delphi-like consensus.Acta diabetologica · 2026Article
- Therapeutic Inertia in Type 2 Diabetes in Indian Primary Care: A Scoping Review.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Review
- ADD2Dia: Real-World Clinical Effectiveness of Adding a Sodium-Glucose Cotransporter 2 Inhibitor to Gliclazide-Based Therapy in Type 2 Diabetes.Advances in therapy · 2025Article
- Effects of a Digital Health Intervention for Adults With Type 2 Diabetes Mellitus on Health Care Resource Use and Health Care Charges in the United States: Retrospective Cohort Study.Journal of medical Internet research · 2025Article
- Article
- Current Status of Delay in Injectable Therapy among Type 2 Diabetes Mellitus Patients in South Korea: Multicenter Retrospective Study (2015-2021).Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Practical limitations of complex insulin therapies in type 2 diabetes: Focus on therapy simplification using fixed-ratio combinations of basal insulin and a glucagon-like peptide-1 receptor agonist.Diabetes, obesity & metabolism · 2025Review
- Clinical outcomes of a real-world prospective study using Dexcom ONE continuous glucose monitoring in people with diabetes treated with two or more insulin injections per day.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Removing barriers to management of adults with type 2 diabetes on insulin using continuous glucose monitoring in UK primary care practice: An expert consensus.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Revolutionizing Diabetes Care: From Tech to Therapeutics.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Achieving equitable access to incretin-based therapies in cardiovascular care.American heart journal plus : cardiology research and practice · 2024Article
- Current barriers to initiating insulin therapy in individuals with type 2 diabetes.Frontiers in endocrinology · 2024Review
- Economic Evaluation of Once-Weekly Insulin Icodec from Italian NHS Perspective.ClinicoEconomics and outcomes research : CEOR · 2024Article
- The Dexcom Community Glucose Monitoring Project: 6-Month Results Using Continuous Glucose Monitoring in Type 2 Diabetes.Clinical diabetes : a publication of the American Diabetes Association · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Therapeutic inertia leading to delays in insulin initiation or intensification is a major contributor to lack of optimal diabetes care. This report reviews the literature summarizing data on therapeutic inertia and delays in insulin intensification in the management of type 2 diabetes. Methods: A literature search was conducted of the Allied & Complementary Medicine, BIOSIS Previews, Embase, EMCare, International Pharmaceutical Abstracts, MEDLINE, and ToxFile databases for clinical studies, observational research, and meta-analyses from 2012 to 2022 using search terms for type 2 diabetes and delay in initiating/intensifying insulin. Twenty-two studies met inclusion criteria. Results: Time until insulin initiation among patients on two to three antihyperglycemic agents was at least 5 years, and mean A1C ranged from 8.7 to 9.8%. Early insulin intensification was linked with reduced A1C by 1.4%, reduction of severe hypoglycemic events from 4 to <1 per 100 person-years, and diminution in risk of heart failure (HF) by 18%, myocardial infarction (MI) by 23%, and stroke by 28%. In contrast, delayed insulin intensification was associated with increased risk of HF (64%), MI (67%), and stroke (51%) and a higher incidence of diabetic retinopathy. In the views of both patients and providers, hypoglycemia was identified as a primary driver of therapeutic inertia; 75.5% of physicians reported that they would treat more aggressively if not for concerns about hypoglycemia. Conclusion: Long delays before insulin initiation and intensification in clinically eligible patients are largely driven by concerns over hypoglycemia. New diabetes technology that provides continuous glucose monitoring may reduce occurrences of hypoglycemia and help overcome therapeutic inertia associated with insulin initiation and intensification.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.