Prevalencia y factores asociados inercia Terapéutica en inicio insulinización, pacientes con diabetes tipo 2, Hospital José Carrasco Arteaga. Cuenca, 2018

Abstract

Background: type 2 diabetes (T2DM) is considered a significant health problem worldwide and in Ecuador; first-line treatment is oral antidiabetic drugs administered in the absence of indications for insulinization. If oral therapy fails, insulin is administered, which is the most potent anti-hyperglycemic agent available. Objective: to determine the prevalence of therapeutic inertia at the time of initiating insulinization in patients with type 2 diabetes, at the Hospital “José Carrasco Arteaga”, in the city of Cuenca, in 2018. Methodological design: observational, analytical, cross-sectional study. The universe was made up of 3581 outpatients of Endocrinology and Internal Medicine of the Hospital

"José Carrasco Arteaga" in 2018, of which a total of 3,159 were excluded, due to non- compliance with inclusion criteria, leaving 422 clinical records of patients with a diagnosis

of DM2, who have received two oral antidiabetic drugs for a period greater than three months. Sociodemographic, clinical and therapeutic variables were measured. The data collection was carried out from the records in medical records, in a form designed for the study. The analysis was done in the SPSS v.25 program, applying descriptive statistics and chi-square association, under a significance of 0.05; and the type of association was calculated using Odds Ratio (OR), with 95% confidence intervals. Results: the sample consisted of 422 diabetic patients with oral treatments; Of the total, 59.2% are 65 years or older, 54.7% were women, 35.8% had completed secondary school, 46.7% were overweight, 96.7% had three or more years of evolution with the disease, 63.7% performed glycemic control. 61.6% presented arterial hypertension as the main comorbidity, 87% indicated Metformin plus Glibenclamide; 86.3% have received treatment for more than three months. 25.8% presented therapeutic inertia and, of these, 75.2% were related to health personnel. There was a significant association between therapeutic inertia and glycemic control, treatment time and nephropathies (p <0.05). Conclusions: therapeutic inertia occurred in one of every four diabetic patients and in most cases it was due to health personnel. Measures should be implemented to reduce therapeutic inertia in patients with DM2.