ArticleDiabetes epidemiology and management2026
Association Between Therapeutic Inertia and Future Hypoglycemia Among Patients with Type 2 Diabetes.
Article in Diabetes epidemiology and management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Therapeutic inertia (TI), the failure to adjust therapy when HbA1c remains above- target, is a barrier to optimal glycemic control in type 2 diabetes (T2D). This study examined the association between TI and subsequent-year hypoglycemia visit, and whether continuous glucose monitoring (CGM) modifies this relationship. Methods: We analyzed electronic health records (2017-2023) from two Midwest US healthcare systems, including adults with T2D, at least one above-target HbA1c (>7% for ages 18-64; >8% for ages ≥65), and glucose-lowering prescriptions. TI was calculated annually as the percentage of above-target HbA1c results without prescription changes within 30 days. We fitted logistic regression models to examine whether high TI (>50%) was associated with subsequent-year hypoglycemia visits. An interaction term tested whether this association differed between those who used vs. did not use CGM. Results: Among 65,983 participants (mean age 56, 51% male, 75% White), mean HbA1c at last follow-up was 8.1% (ages 18-64) and 8.0% (ages ≥ 65). High TI was associated with 31% increased odds of hypoglycemia visit (OR=1.74; 95% CI: 1.61-1.88; Conclusions: In this cohort, high TI predicted hypoglycemia-visit. Further research is needed to understand TI drivers and how to balance improving glycemic control without increasing the risk of hypoglycemia.
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