{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:01:28Z","timestamp":1784001688986,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Treatment intensification is commonly delayed in people with type\u00a02 diabetes, resulting in poor glycemic control for an unacceptable length of time and increased risk of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This retrospective study investigated clinical inertia in 33,320 Japanese adults with type\u00a02 diabetes treated with oral antidiabetic drugs (OADs) between 2009 and 2018, using data from the Computerized Diabetes Care (CoDiC<jats:sup>\u00ae<\/jats:sup>) database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median time from first reported glycated hemoglobin (HbA1c) \u22657.0% (\u226553\u00a0mmol\/mol) to treatment intensification was considerably longer and HbA1c levels were higher the more OADs the patient was exposed to. For patients receiving three OADs, the median times from HbA1c \u22657.0% (53\u00a0mmol\/mol) to intensification with OAD, glucagon\u2010like peptide\u20101 receptor agonist or insulin were 8.1, 9.1 and 6.7\u00a0months, with a mean HbA1c level at the time of intensification of 8.4%, 8.9% and 9.3%, respectively. The cumulative incidence for time since the first reported HbA1c \u22657.0% (\u226553\u00a0mmol\/mol) to intensification confirmed the existence of clinical inertia, identifying patients whose treatment was not intensified despite poor glycemic control. HbA1c levels \u22657.0% (\u226553\u00a0mmol\/mol) after \u22656\u00a0months on one, two or three OADs were observed in 42%, 51% and 58% of patients, respectively, showing that approximately 50% of patients are above HbA1c target regardless of how many OADs they take.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Real\u2010world data here show clinical inertia in Japanese adults with type\u00a02 diabetes from early diabetes stages when they are receiving OADs, and illustrate a need for earlier, more effective OADs or injectable treatment intensification and better communication around the existence of clinical inertia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.13352","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T05:20:05Z","timestamp":1594272005000},"page":"374-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical inertia in patients with type\u00a02 diabetes treated with oral antidiabetic drugs: Results from a Japanese cohort study (JDDM53)"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4611-8149","authenticated-orcid":false,"given":"Hiroshi","family":"Maegawa","sequence":"first","affiliation":[{"name":"Department of Medicine Shiga University of Medical Science Otsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2479-5752","authenticated-orcid":false,"given":"Yasushi","family":"Ishigaki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Iwate Medical University Morioka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Langer","sequence":"additional","affiliation":[{"name":"Novo Nordisk Pharma Ltd Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Saotome\u2010Nakamura","sequence":"additional","affiliation":[{"name":"Novo Nordisk Pharma Ltd Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Andersen","sequence":"additional","affiliation":[{"name":"StatGroup ApS Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Japan Diabetes Clinical Data Management (JDDM) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Ministry of Health Labour and Welfare.National Health and Nutrition Survey [article online] 2018. Available fromhttp:\/\/www.nibiohn.go.jp\/eiken\/kenkounippon21\/en\/eiyouchousa\/kekka_todoufuken_h28.htmlAccessed 2 September 2019."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.10.2540"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0806470"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60697-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7258.405"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0958"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-S301"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S009"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12810"},{"key":"e_1_2_7_11_1","unstructured":"International Diabetes Federation.Recommendations for managing type 2 diabetes in primary care [article online] 2017. Available fromhttps:\/\/www.idf.org\/e\u2010library\/guidelines\/128\u2010idf\u2010clinical\u2010practice\u2010recommendations\u2010for\u2010managing\u2010type\u20102\u2010diabetes\u2010in\u2010primary\u2010care.html. Accessed 2 September 2019."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.4158\/CS-2018-0535"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S012"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2016.09.003"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13132"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-0331"},{"key":"e_1_2_7_17_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_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-009-0158-8"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2007.02279.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2006.01.013"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12183"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198160"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2012.01602.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2013.11.010"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0116"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2017.06.003"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2016-000294"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12956"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-2170"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.05.005"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2016.1190701"}],"container-title":["Journal of Diabetes Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjdi.13352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdi.13352","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdi.13352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T12:42:02Z","timestamp":1693658522000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdi.13352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/jdi.13352"],"URL":"https:\/\/doi.org\/10.1111\/jdi.13352","archive":["Portico"],"relation":{},"ISSN":["2040-1116","2040-1124"],"issn-type":[{"value":"2040-1116","type":"print"},{"value":"2040-1124","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"2020-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}