The prevalence of diabetes has increased within the recent decade. Today, approximately 37 million people in the United States have diabetes mellitus. Not only is there a physical cost to this disease, but there is a financial one as well. Medical costs for diabetes are twice as high when compared with those who don’t have the disease.
Richard S. Rosenthal, MD, and Angela Thompson, DNP, FNP-C, BC-ADM, CDES, FAANP, talked about type 2 diabetes and the treatment of the disease in their presentation titled, “Addressing Therapeutic Inertia and Basal Insulin Use in T2D,” which was presented at the Practical Updates in Primary Care 2022 Virtual Series. Dr Rosenthal is a professor of medicine in the Division of Endocrinology, Diabetes and Metabolism at the University of Alabama at Birmingham in Birmingham, Alabama, and Dr Thompson is a family nurse practitioner at Hendricks Endocrinology in Danville, Indiana.
Dr Rosenthal introduced the session by going over the numbers associated with diabetes mellitus—including the estimated overall cost of treatment in the US, the complications associated with diabetes, and how clinicians can approach the treatment of the disease. 
Dr Thompson continued the presentation by talking about therapeutic inertia with type 2 diabetes. She defined this as “the underuse of effective therapies in preventing serious clinical end points despite abundant evidence showing benefit …” Dr Thompson related therapeutic inertia to both provider care and patient-related factors.
Further, Dr Thompson discussed the long-acting insulin options for patients, which she described as the “new generation” of insulins. She reviewed how the different types of basal insulins impact therapeutic inertia and management of type 2 diabetes and detailed the emerging treatments using basal insulin.
To conclude their presentation, Dr Rosenthal presented case studies involving patients with type 2 diabetes, sharing the recommended strategies for treating each patient. Dr Rosenthal highlighted the importance of glycemic control, and examples of basal insulin can be implemented in treatment.
“Hopefully these case presentations showed you a method of thinking about your patients, thinking about their hemoglobin A1C, and also trying to come up with an option to treat them to get them at goal,” Dr Rosenthal concluded.
For additional meeting coverage, visit the Practical Updates in Primary Care newsroom.
For more information about PUPC 2022 Virtual Series and to register for upcoming sessions, visit
—Jessica Ganga
Rosenthal RS, Thompson A. Addressing therapeutic inertia and basal insulin use in T2D. Talk presented at: Practical Updates in Primary Care 2022 Virtual Series; November 16, 2022; Virtual.


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