OBJECTIVES: Therapeutic inertia in diabetes has been associated with increased cardiovascular risk, complications, and higher health costs; therefore, its understanding, early detection, and prevention are important. The aim of the present study was to evaluate therapeutic inertia (TI) in patients with type 2 diabetes mellitus (DM2) treated in a health care institution in Colombia.

METHODS: Retrospective observational study in a dynamic cohort of patients (n=11,969) with confirmed diagnosis of DM2, between January 2017 and March 2023, including clinical, cost, and demographic data. IT was determined in uncontrolled patients (A1c>7%) who would not have had an intensification or change of treatment within 6 months. First, descriptive analyses of the cohort were developed, then, to reduce confounding biases of baseline variables, a propensity score matching model was conducted. Finally, a logistic regression model was implemented to determine the association of variables with the presence of therapeutic inertia.

RESULTS: TI was identified in 6,245 patients, 52.7% (95% CI 51.3 - 53.1). The cumulative incidence was 22.9 cases per 100 person-years. The average time in the program was 10.75 months (CI 10.51-11.00) of the 75 months analyzed. Costs of care were 35.6% higher in patients with therapeutic inertia. Matching was performed using the variables age, gender, duration in program, and A1c goals at baseline. Finally, with a significance level of 99%, the predictor variables of TI in the regression model were: gender, duration in program, A1c goals and costs.

CONCLUSIONS: Therapeutic inertia was highly incident and was related to unfavorable conditions in the goals of diabetes control and higher costs. This results will help to make decisions in the health institution in order to obtain the best clinical and financial results.