Evidence map›Paper›PMID 42245269›Full record

ReviewDiabetes, metabolic syndrome and obesity : targets and therapy2026

Therapeutic Inertia in Type 2 Diabetes in Indian Primary Care: A Scoping Review.

Lokesh Shanmugam, Siva Ranganathan Green, A Sathya, Joshua Chadwick

Abstract readReview
In one paragraph

Review in Diabetes, metabolic syndrome and obesity : targets and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Lokesh ShanmugamIndian Council of Medical Research-National Institute of Epidemiology, Chennai, Tamil Nadu, India.ORCID 0000-0003-4348-1572
Siva Ranganathan GreenInternal Medicine Department, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India.ORCID 0000-0001-7325-8318
A SathyaInternal Medicine Department, Government Stanley Medical College, Chennai, Tamil Nadu, India.ORCID 0009-0009-9169-2367
Joshua ChadwickIndian Council of Medical Research-National Institute of Epidemiology, Chennai, Tamil Nadu, India.ORCID 0000-0002-8636-0634

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Therapeutic inertia (TI) is a significant barrier to achieving optimal glycaemic control in type 2 diabetes mellitus (T2DM), particularly in primary health care (PHC) settings in India. Despite growing global attention, evidence from Indian PHC remains limited and fragmented. Methods: A scoping review was conducted following PRISMA-ScR guidelines. A systematic search of electronic databases and relevant policy documents was performed to identify studies published between 2010 and 2025. Studies addressing therapeutic inertia in T2DM at global and Indian levels were included and thematically analysed. Results: The findings indicate that global evidence on therapeutic inertia is extensive, highlighting delays in treatment intensification, clinical decision-making challenges, and health system inefficiencies. In contrast, Indian evidence is relatively limited and predominantly derived from urban and tertiary care settings. Across studies, therapeutic inertia was influenced by multiple factors, including patient-related barriers (eg, fear and lack of awareness), provider-related factors (eg, clinical conservatism), and system-level constraints (eg, resource limitations). Notably, there is a lack of longitudinal and interventional studies focusing on PHC in India. Conclusion: Therapeutic inertia remains a multifactorial challenge in T2DM management, particularly in Indian PHC settings where evidence gaps persist. Strengthening primary care systems, promoting implementation research, and developing context-specific interventions are essential to address this issue and improve diabetes outcomes.

Indexed as

glycemic controlNPCDCSprimary health carePRISMA-ScRtherapeutic inertiatype 2 diabetes mellitus

Identifiers

PMID42245269
PMCPMC13231883

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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.