Diabetes is one of the fastest growing global health problems. In 2019, 463 million people lived with diabetes and this number will increase to 578 million in 2030. Furthermore, patients fail to reach glycemic control. This could be due to clinical inertia that is a failure to initiate or intensify therapy when glycemic control is not achieved. Colombian Diabetes Mellitus National Guidelines(CNG), defined treatment recommendations and it´s important to know the level of adherence to them.

OBJECTIVES : To estimate the prevalence of clinical inertia in newly diagnosed T2DM patients in healthcare institutions in Colombia.

METHODS : Retrospective cohort study. The setting were two HMOs(subsidized regimen(SR) and contributory regimen(CR)). Clinical inertia was defined as failure to initiate or intensify therapy in a timely manner(at diagnosis and/or 3 to 6 months after diagnosis) according to local evidence-based CNG. Sources of the data were databases of the two HMOs. Variables to determine initial inertia were date of diagnosis, HbA1c level at diagnosis, type of treatment time between the diagnosis and pharmacological treatment. Variables for follow-up inertia were follow-up HbA1c(date/level), addition of new medication and type of treatment added.

RESULTS : Initial inertia occurred in 58.6% of patients(361 of 616),52% were from CR(188 of 361) and 48% from SR(173 of 361). It was identified inadequate treatment in 84.5% and late dispensing (>30days) in 15.5% of cases. Follow-up inertia was found in 84.3% of patients without initial inertia(215 of 255) and associated factors were non-HbA1c between 3-6 months after diagnosis (93%) and inadequate treatment adjustment (7%). Only 6,9% of patients achieved goals based on CNG.

CONCLUSIONS : In this study, initial and follow-up clinical inertia constitutes a major issue for diabetic population and shows an inadequate adherence to CNG. This information may help payers and clinicians streamline strategies for reducing clinical inertia and improve patient outcomes.