Table 4

Potential causes of clinical inertia in T2D

Failure of clinicians to fully appreciate the progressive nature of T2D consequent to β-cell failure
A clinician’s lack of understanding about the frequent failure of monotherapy and that most patients will ultimately require combination therapy
A clinician’s and/or patient’s fear of hypoglycemia and weight gain when intensifying therapy, particularly with sulfonylureas or insulin
A clinician’s lack of confidence, particularly when working in the primary care setting, in using insulin
Poor recognition, by clinicians, of the evidence that demonstrates the benefits of early glycemic control
A clinician’s general reluctance to use combination therapy early after diagnosis