{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:39:41Z","timestamp":1781264381098,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T00:00:00Z","timestamp":1468281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clinical inertia is a failure to intensify treatment according to evidence\u2010based guidelines, and can have both short\u2010 and long\u2010term 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\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted at a university\u2010based hospital in Thailand. Medical records were evaluated retrospectively from January 2010 to December 2014. Patients were classified into two groups: clinical inertia and non\u2010inertia. Clinical inertia was defined as failure to initiate insulin within 3\u2009months in patients with HbA1c \u22659\u00a0% who were already taking two oral antidiabetic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1206 records, 98 patients with mean HbA1c of 10.3\u00a0% were identified and enrolled in the study. The median follow\u2010up time of these patients was 29.5\u2009months and 68.4\u00a0% were classified into the clinical inertia group. The mean (\u00b1 SD) HbA1c decrement in the clinical inertia and non\u2010inertia groups was 0.82\u2009\u00b1\u20091.50\u00a0% and 3.02\u2009\u00b1\u20091.80\u00a0%, respectively, at 6\u2009months (<jats:italic>P<\/jats:italic>\u2009&lt;\u00a00.001) and 1.46\u2009\u00b1\u20091.85\u00a0% and 3.04\u2009\u00b1\u20091.76\u00a0%, respectively, at the end of study (<jats:italic>P<\/jats:italic>\u2009&lt;\u00a00.001). Clinical inertia was associated with a significantly shorter median time to progression of diabetic retinopathy (DR); log rank test, <jats:italic>P<\/jats:italic>\u2009=\u20090.02 and a higher incidence of DR progression (10 vs 2.2 cases per 1000 person\u2010months; <jats:italic>P<\/jats:italic>\u2009=\u20090.003). The adjusted incidence rate ratio for DR progression in the clinical inertia group was 4.92 (95\u00a0% confidence interval 1.11\u201321.77; <jats:italic>P<\/jats:italic>\u2009=\u20090.036). Being treated by general practitioners was the strongest risk factor associated with clinical inertia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clinical inertia can cause persistently poor glycemic control and speed up the progression of DR in T2D.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1753-0407.12410","type":"journal-article","created":{"date-parts":[[2016,4,19]],"date-time":"2016-04-19T23:14:07Z","timestamp":1461107647000},"page":"267-274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Clinical inertia causing new or progression of diabetic retinopathy in type 2 diabetes: A retrospective cohort study"],"prefix":"10.1111","volume":"9","author":[{"given":"Soravis","family":"Osataphan","sequence":"first","affiliation":[{"name":"Faculty of Medicine Srinakharinwirot University  Nakhon Nayok Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thep","family":"Chalermchai","sequence":"additional","affiliation":[{"name":"School of Anti\u2010aging and Regenerative Medicine Mae Fah Luang University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4392-269X","authenticated-orcid":false,"given":"Kanchana","family":"Ngaosuwan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine Srinakharinwirot University  Nakhon Nayok Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,12]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Diabetes Clinical Practice Guideline","author":"Diabetes Association of Thailand, The Endocrine Society of Thailand, Department of Medical Services, National Health Security Office Thailand","year":"2011"},{"key":"e_1_2_9_3_1","volume-title":"Diabetes Clinical Practice Guideline","author":"Diabetes Association of Thailand, The Endocrine Society of Thailand, Department of Medical Services, National Health Security Office Thailand","year":"2014"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-S010"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-0331"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2010.07.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.3.600"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.892248"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145721705279050"},{"key":"e_1_2_9_10_1","first-page":"455","article-title":"Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: Retrospective cohort study","volume":"57","author":"Calvert MJ","year":"2007","journal-title":"Br J Gen Pract"},{"key":"e_1_2_9_11_1","first-page":"501","article-title":"Outcomes and treatment patterns of adding a third agent to 2 OADs in patients with type 2 diabetes","volume":"20","author":"Levin PA","year":"2014","journal-title":"J Manag Care Pharm"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-015-0260-x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1988.tb01003.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001288"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(03)00475-5"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-9032"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1185\/030079904X1980"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6823-9-19"}],"container-title":["Journal of Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1753-0407.12410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1753-0407.12410","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1753-0407.12410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:39:21Z","timestamp":1695515961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1753-0407.12410"}},"subtitle":["\u4e34\u5e8a\u60f0\u6027\u53ef\u5bfc\u81f42\u578b\u7cd6\u5c3f\u75c5\u60a3\u8005\u65b0\u53d1\u89c6\u7f51\u819c\u75c5\u53d8\u6216\u89c6\u7f51\u819c\u75c5\u53d8\u8fdb\u5c55:\u4e00\u9879\u56de\u987e\u6027\u961f\u5217\u7814\u7a76"],"short-title":[],"issued":{"date-parts":[[2016,7,12]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1111\/1753-0407.12410"],"URL":"https:\/\/doi.org\/10.1111\/1753-0407.12410","archive":["Portico"],"relation":{},"ISSN":["1753-0393","1753-0407"],"issn-type":[{"value":"1753-0393","type":"print"},{"value":"1753-0407","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,12]]},"assertion":[{"value":"2016-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}