Frequency and associated factors with therapeutic inertia at the start of insulin therapy in patients with Diabetes Mellitus II, Hospital José Carrasco Arteaga. Cuenca, 2018

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BACKGROUND: Diabetes Mellitus II is a global health issue, with no exception in Ecuador. The pharmacological treatment of DM2 is based on a stepped scheme, which varies according to the patients’ needs, the disease course, and the glycaemic control. The delay in the treatment intensification or the insulin initiation, known as therapeutic inertia, is caused by different factors attributable to both the patient and the health care systems, increasing the risk of both micro and macrovascular chronic complications. METHODS: we carried out an observational, cross-sectional, descriptive and correlation study. 422 patients from the Endocrinology and Internal Medicine outpatient clinic of “Hospital José Carrasco Arteaga” in 2018, with DM2 diagnosis, who received two oral antidiabetic drugs as treatment were studied; with the purpose of identifying the frequency and associated factors with therapeutic inertia in these patients. Data was collected from medical records in a form designed for this study. The data analysis was made in the SPSS v.25 software, applying descriptive statistics and correlation statistics with Chi-square test, with a confidence level of 95%. RESULTS: 59.2% of the sample was 65 years or older, 54.7% were women, 46.7% were overweight and 36% were obese. 96.7% had three or more years of diagnosis of the disease, 63.7% had adequate glycaemic control. The most frequent comorbidity was hypertension, which occurred in 61.6% patients. 87% were using Metformin plus Glibenclamide as treatment. 86.3% were receiving their current treatment for more than three months. Therapeutic inertia presented in 25.8% of the sample, and of these cases, inertia was related to health personnel in 75.2%. CONCLUSION: therapeutic inertia presented in 25.8% of the sample. Most of the therapeutic inertias were related to the health personnel. No significant statistically association was found between the occurrence of therapeutic inertia with age, sex, educational level, comorbidities, nutritional status or years of evolution of DMII.