Informative, Actionable Diabetes Content
Watch our webinars and listen to our podcasts to get more practical advice on how to tackle therapeutic inertia in your practice.
Learn about the impact of therapeutic inertia on diabetes care and what you can do to overcome it in your practice.
Did you miss the American Diabetes Association®’s live webinar on Initiating, Intensifying and De-intensifying Insulin?
Watch leading diabetes experts share best practices for initiating, intensifying and de-intensifying insulin in patients with type 2 diabetes. The panelists represented federally qualified health centers, primary care practices, and large-scale health systems. Regardless of where you practice, you will gain insights on:
- creating workflows,
- leveraging team-based care,
- avoiding pitfalls to identifying the right patient at the right time with the right dose, and
- recognizing how to overcome barriers to care.
Watch at your own pace. Gain valuable insights. Make a difference in the lives of people with diabetes!
Click here to download ADA’s infographics on initiating, intensifying, and de-intensifying insulin!
The Overcoming Therapeutic Inertia initiative is supported in part by Novo Nordisk and Sanofi Diabetes.
Deploying a team-based approach is necessary to overcome therapeutic inertia in diabetes care. Join us and our strategic alliance partners, ADCES, AANP, APhA, and ASHP for practical tips on how to leverage your team to overcome therapeutic inertia in your practice and positively impact health outcomes.
Special Podcast Series
Despite the development of new technologies, drug therapies, and education programs, the average A1C for a person with diabetes has not changed in the past 20 years. In fact, the number of patients with an A1C over 9% has actually increased. Moreover, less than 20% of patients have lowered their A1C, blood pressure, and LDL cholesterol levels to target ranges. And within 1 year of diagnosis, less than 50% of patients adhere to their prescription regimens.
There are myriad factors that underlie the lack of progress in improving A1C and other outcomes for patients with diabetes. Therapeutic inertia, which refers to the failure to advance, intensify, or adjust therapy as appropriate, is a major contributor.
Diabetes Core Update explores the multiple facets of therapeutic inertia in this special 3-episode series. In each episode, Drs Neil Skolnik and John Russell of Abington Jefferson Health present and discuss the latest clinically relevant articles and information related to the impact of therapeutic inertia, the importance of getting to goal, and the benefits of simultaneous intensification versus sequential treat-to-fail approaches for patients with diabetes.
Users can listen to each episode by clicking on the podcast players below or subscribe on Apple Podcasts or Google Play.
In this third and final episode of the Diabetes Core Update series Disrupting Therapeutic Inertia in Diabetes Management, Dr Neil Skolnik focuses on practical solutions for overcoming therapeutic inertia. To do so, Dr Skolnik discusses various strategies and approaches with 4 master physicians, each of whom provide a unique perspective on how to address therapeutic inertia in the treatment of diabetes.
Dr Eric L. Johnson discusses the importance of understanding and being familiar with the ADA/European Association for the Study of Diabetes algorithm for prescribing and adjusting medications, as well as the importance of planning and communicating next steps with patients at each visit.
Dr William H. Polonsky discusses the importance of creating a sense of urgency around treatment and management, as well as strategies for developing trust with patients in order to guide them to better adherence and diabetes management. Dr Pamela R. Kushner discusses the importance of a team approach to managing patients with diabetes, as well as the usefulness of free patient resources that can help patients with diabetes, including ADA’s Living with Type 2 Diabetes program.
Dr Steven V. Edelman discusses the importance of empathizing with patients and of understanding and acknowledging the difficulties related to managing diabetes in order to encourage patients to better adhere to their treatment protocols. This episode concludes the special 3-part series on therapeutic inertia. This series is supported by an independent educational grant from Sanofi.
In this second episode of the 3-part series Disrupting Therapeutic Inertia in Diabetes Management, Drs John Russell and Neil Skolnik are joined by Dr Stewart Harris of the Schulich School of Medicine and Dentistry, Western University (Toronto), to discuss the causes and consequences of therapeutic inertia. In so doing, Drs Russell, Skolnik, and Harris refer to the following publications:
Harris SB, Cheng AYY, Davies MJ, Gerstein HC, Green JB, Skolnik N. Person-centered, outcomes-driven treatment: a new paradigm for type 2 diabetes in primary care. American Diabetes Association; 2020. PMID: 32667763.
Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426. doi:10.2337/dc17-1144 Epub 2018 Aug 13. PMID: 30104301; PMCID: PMC6385699.
Paul SK, Klein K, Thorsted BL, Wolden ML, Khunti K. Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol. 2015;14:100. doi:10.1186/s12933-015-0260-x PMID: 26249018; PMCID: PMC4528846.
Zhu NA, Harris SB. Therapeutic inertia in people with type 2 diabetes in primary care: a challenge that just won't go away. Diabetes Spectr. 2020;33(1):44-49. doi:10.2337/ds19-0016 PMID: 32116453; PMCID: PMC7026753.
In episode 3, Drs Russell and Skolnik will conclude this special series by examining solutions for overcoming therapeutic inertia. This special 3-part series on therapeutic inertia is supported by independent educational grant from Sanofi.
In this first episode of the 3-part series Disrupting Therapeutic Inertia in Diabetes Management, Drs John Russell and Neil Skolnik examine a case study of a 55-year-old man with type 2 diabetes (3 years duration, A1C 8.2%). In so doing, they review the following 6 articles that define achievement gaps in reaching A1C goals and the reasons for why those gaps exist:
Blonde L, Brunton SA, Chava P, et al. Achievement of target A1C <7.0% (<53 mmol/mol) by U.S. type 2 diabetes patients treated with basal insulin in both randomized controlled trials and clinical practice. Diabetes Spectrum. 2019;32(2)93-103. doi:10.2337/ds17-0082
Carls GS, Tuttle E, Tan RD, et al. Understanding the gap between efficacy in randomized controlled trials and effectiveness in real-world use of GLP-1 RA and DPP-4 therapies in patients with type 2 diabetes. Diabetes Care. 2017;40(11):1469-1478. doi:10.2337/dc16-2725
Kazemian P, Shebl FM, McCann N, Walensky RP, Wexler DJ. Evaluation of the cascade of diabetes care in the United States, 2005-2016. JAMA Intern Med. 2019;179(10):1376-1385. doi:10.1001/jamainternmed.2019.2396
Khunti K, Ceriello A, Cos X, De Block C. Achievement of guideline targets for blood pressure, lipid, and glycaemic control in type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2018;137:137-148. doi:10.1016/j.diabres.2017.12.004
Khunti K, Wolden ML, Thorsted BL, Andersen M, Davies MJ. Clinical inertia in people with type 2 diabetes. Diabetes Care. 2013;36(11):3411-3417. doi:10.2337/dc13-0331
Pantalone KM, Wells BJ, Chagin KM, et al. Intensification of diabetes therapy and time until A1C goal attainment among patients with newly diagnosed type 2 diabetes who fail metformin monotherapy within a large integrated health system. Diabetes Care. 2016;39(9):1527-1534. doi:10.2337/dc16-0227
In episodes 2 and 3 of this series, Drs Russell and Skolnik will look at additional causes of therapeutic inertia and solutions for overcoming it. This special 3-part series on therapeutic inertia is supported by an independent educational grant from Sanofi
Diabetes Core Update discusses the latest articles from ADA’s 4 scholarly journals: Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5 to 6 recently published articles. Intended for the busy health care professional who has little time to review journal articles in depth, Diabetes Core Update discusses how the latest research and information published in ADA journals are relevant to clinical practice and can be applied in a treatment setting.
Diabetes Core Update podcasts are free and can be accessed through Apple Podcasts, Google Play, or RSS feed. For more information about RSS feeds, see ADA Journals RSS Feeds. The podcasts are also accessible for listening on your computer or mobile device and can be downloaded below.
Heerspink HJL, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020;383:1436-1446. doi:10.1056/NEJMoa2024816
Leino AD, Dorsch MP, Lester CA, et al. Changes in statin use among U.S. adults with diabetes: a population-based analysis of NHANES 2011–2018. Diabetes Care. 2020;43(12):3110-3112. doi:10.2337/dc20-1481
Mirani M, Favacchio G, Carrone F, et al. Impact of comorbidities and glycemia at admission and dipeptidyl peptidase 4 inhibitors in patients with type 2 diabetes with COVID-19: a case series from an academic hospital in Lombardy, Italy. Diabetes Care. 2020;43(12):3042-3049. doi:10.2337/dc20-1340
Packer M, Anker SD, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383:1413-1424. doi:10.1056/NEJMoa2022190
Seiglie J, Platt J, Cromer SJ, et al. Diabetes as a risk factor for poor early outcomes in patients hospitalized with COVID-19. Diabetes Care. 2020;43(12):2938-2944. doi:10.2337/dc20-1506