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

Background Clinical inertia is a failure to intensify treatment according to evidence‐based guidelines, and can have both short‐ and long‐term adverse effects for type 2 diabetes (T2D). The aim of the present study was to demonstrate the effects of clinical inertia on glycemic control and diabetes‐related complications. Methods A retrospective cohort study was conducted at a university‐based hospital in Thailand. Medical records were evaluated retrospectively from January 2010 to December 2014. Patients were classified into two groups: clinical inertia and non‐inertia. Clinical inertia was defined as failure to initiate insulin within 3 months in patients with HbA1c ≥9 % who were already taking two oral antidiabetic agents. Results From 1206 records, 98 patients with mean HbA1c of 10.3 % were identified and enrolled in the study. The median follow‐up time of these patients was 29.5 months and 68.4 % were classified into the clinical inertia group. The mean (± SD) HbA1c decrement in the clinical inertia and non‐inertia groups was 0.82 ± 1.50 % and 3.02 ± 1.80 %, respectively, at 6 months (P