Analysis of Factors Influencing Clinical Inertia in the Treatment of Type 2 Diabetes Mellitus Patients With Metformin.

Abstract

Aims/Background Medication therapy is a crucial measure for type 2 diabetes mellitus (T2DM). However, approximately 50% of diabetes patients in China fail to achieve their blood glucose control targets despite receiving hypoglycemic treatment. Studies have indicated that clinical inertia is often a key factor contributing to poor long-term blood glucose control in most patients. This study aims to investigate the factors influencing clinical inertia in the treatment process of patients using metformin. Methods A retrospective study method was adopted, and 86 T2DM patients treated with metformin who have clinical inertia between June 2021 and June 2023 at Zhejiang Hospital were treated as the inertia group. Additionally, 87 patients who received the same medication treatment and follow-up evaluation without clinical inertia during the same period were selected as the control group. By comparing general data, family and economic situations, lifestyle, and diabetes conditions between the two groups, a logistic multivariate analysis model was used to analyze the factors influencing clinical inertia in the treatment process of T2DM patients using metformin. Results The proportion of male patients and those with an elementary education or below was significantly higher in the inertia group compared to the control group (p < 0.05). Additionally, the proportion of patients without commercial insurance was significantly higher in the inertia group (p < 0.05). The proportion of patients practicing dietary control was lower in the inertia group compared to the control group (p < 0.05). Furthermore, the inertia group had a lower proportion of patients with initial glycated hemoglobin levels ≥8.0%, those conducting home blood glucose monitoring, patients with diabetes-related complications, and those receiving diabetes health education compared to the control group (p < 0.05). Male gender (odds ratio (OR) = 3.487, p = 0.001), elementary education or below (OR = 2.362, p = 0.027), lack of commercial insurance (OR = 3.783, p = 0.005), absence of home blood glucose monitoring (OR = 3.127, p = 0.007), absence of diabetes-related complications (OR = 2.995, p = 0.006), and lack of chronic disease health education (OR = 2.753, p = 0.017) were identified as risk factors for clinical inertia in the treatment of T2DM patients using metformin (p < 0.05). Conclusion The risk of clinical inertia during metformin treatment in T2DM patients is relatively high and is associated with various factors. Targeted intervention measures should be implemented for high-risk populations to reduce the risk of clinical inertia.