OBJECTIVES: Therapeutic inertia (failure to intensify therapy to address poor glycemic control in a timely manner) has been widely reported in the UK despite the well-established importance of maintaining good glycemic control. The aim of the present study was to evaluate the impact on life expectancy of poor glycemic control due to therapeutic inertia for the type 2 diabetes population in the UK.

METHODS: A validated long-term model (IQVIA CORE Diabetes Model) was used to project outcomes for a population with type 2 diabetes based on data from The Health Improvement Network primary care database. Life expectancy and complication rates were estimated for populations achieving different glycated hemoglobin (HbA1c) targets in a range of delayed treatment intensification scenarios. Population estimates of burden were based on epidemiological studies and published studies of glycemic targets in the UK.

RESULTS: Published data indicates that approximately 1,163,547 patients with type 2 diabetes in the UK have poor glycemic control (failing to meet HbA1c targets). Assuming a mean baseline HbA1c level of 8.2% (66 mmol/mol) in line with primary care data, 1 year of poor control was projected to cost 5,818 life years in a population of this size versus good glycemic control (HbA1c 7.0%, 53 mmol/mol) over a 3-year time horizon. Assuming a 5-year time horizon, approximately 15,126 years of life were lost in the population with only 1 year of poor glycemic control (HbA1c 8.2% [66 mmol/mol]) versus good glycemic control (HbA1c 7.0%, 53 mmol/mol).

CONCLUSIONS: The clinical burden associated with poor glycemic control in type 2 diabetes in the UK is substantial. Efforts to avoid therapeutic inertia could substantially improve outcomes for the type 2 diabetes population even in the short term.