The Diabetes Podcast®

Episode 14 - Clinical Inertia


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Clinical Inertia and Type 2 Diabetes: Why Care Gets Stuck and How to Unstick It

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In this Diabetes Podcast episode, Richie and Amber break down Clinical Inertia in type 2 diabetes—why care stalls, why A1C goals get missed, and simple steps you can start today to protect your health and aim for remission.

Keywords: Clinical Inertia, type 2 diabetes, A1C, remission, insulin resistance, beta cells, primary care, diabetes education, lifestyle change

Episode summary

You leave the doctor’s office scared. You hear “eat better, move more,” and “see you in three months.” No plan. No help. Then your A1C is higher, and you get another med. You feel stuck.

In this episode, we name the problem: Clinical Inertia. It’s when treatment does not start or does not get stronger when the A1C says it should. It’s common. It is not your fault. It is not because doctors do not care. It is the system, short visits, too many problems to cover, and not enough time for real support.

We explain why this happens, what it costs, and what actually works. We talk about the best window for remission. We give simple actions you can start today. You can take back control. You can change your story.

What we cover
  • What Clinical Inertia is, in plain words
  • Why short visits (about 16 minutes) lead to missed care steps
  • Why so many people leave visits without a clear plan
  • How delays hurt A1C goals and long-term health
  • Why “more meds” without lifestyle change is not enough
  • The best time window for type 2 diabetes remission
  • Simple daily steps that help right now
  • How to own your health outside the clinic
Timestamps
  • 00:00 — The scary first visit, and why people feel lost
  • 00:02 — How most people find out they have type 2 (a quick call, then Google chaos)
  • 00:04 — Short visits, many problems, and “triage” in primary care
  • 00:05 — Clinical Inertia defined
  • 00:09 — Where lifestyle help breaks down; insurance and “info dump” classes
  • 00:14 — Classes lower A1C a bit, but overload is real
  • 00:16 — 1 in 3 misunderstand the plan; 60% leave without clear “what to eat/do”
  • 00:18 — Clinical Inertia drives about 80% of missed A1C goals
  • 00:20 — Med stacking vs fixing insulin resistance; why lifestyle is powerful
  • 00:23 — Why higher A1C = higher risk (simple stats you should know)
  • 00:25 — How fast meds pile up for many people
  • 00:26 — The best window for remission is early (1–3 years post-diagnosis)
  • 00:27 — Your beta cells need urgent help; delays matter
  • 00:29 — When doctors say “I can’t help more,” and why that happens
  • 00:30 — The big system problem vs what you can do now
  • 00:31 — Own your health like your money: day-to-day is on you
  • 00:35 — Hope: remission is real; behavior change works
  • 00:35 — Simple steps to start today
  • 00:38 — When A1C is “flat, flat… then jumps,” that’s inertia
  • 00:38 — Free resources and fast-track help at EmpoweredDiabetes.com
  • 00:39 — Closing: You deserve a plan, a partner, and real change
Clinical Inertia: what it is and why it happens
  • Simple meaning: care does not start or does not ramp up when your A1C shows it should.
  • Why it happens:
    • Primary care doctors care for 1,800–2,000 patients.
    • Visits are short (about 16 minutes).
    • About six problems per visit. Diabetes competes with other urgent issues.
    • Real life happens: floods, stress, pain. Doctors are human and try to help with what’s most urgent.
    • Group classes are often “info dumps.” People leave overwhelmed.
    • Insurance pays for very limited visits. Not much for ongoing support.
What Clinical Inertia costs
  • About 80% of people who miss their A1C goals do so because care was delayed, diluted, or dismissed.
  • Many leave visits confused:
    • 1 in 3 misunderstand the plan after a standard visit.
    • Over 60% leave without clear steps on what to eat or do.
  • Risks rise as A1C rises (UKPDS 1% rule):
    • For each 1% A1C above 7:
      • 21% higher risk of death due to diabetes
      • 14% higher risk of heart attack
      • 37% higher risk of small blood vessel damage (eyes, kidneys, nerves)
    • An A1C of 9 can double the risk of kidney failure, blindness, and stroke over time.
Why “more meds” alone is not the fix
  • What often happens: metformin → add-ons (like DPP-4, SGLT2) → more meds → insulin.
  • These can help, but many do not fix insulin resistance, the core problem.
  • Without lifestyle change, meds pile up while the root issue stays.
  • Data shows:
    • Within 5 years, about 50% are on multiple meds.
    • About one-third are on three or more.
The best window for remission
  • Remission is most likely in the first 1–3 years after diagnosis.
  • Every 6–12 month delay lowers the chance.
  • Why? Your beta cells (the insulin-making cells) get tired and fewer over time.
  • Early action protects these cells. That helps long-term control.
What your doctor sees (and why they push meds)
  • Doctors see the whole road: from first A1C rise to ulcers, eye damage, and amputations.
  • They know many people cannot make big changes fast. So they push meds to protect you now.
  • They are not the enemy. The system is hard. The time is short. The stakes are high.
How to fight Clinical Inertia: take charge outside the clinic

Your health is too important to leave to short visits. Think of your health like money: daily choices matter most. You have power. Start small. Start now.

Simple steps you can start today
  • After each meal, walk for 2 minutes. Yes, just two. It helps your blood sugar.
  • Track one number daily: before-and-after meal blood sugar or a step count.
  • Cut one source of added sugar today (soda, sweetened coffee, juice).
  • Build a “default plate”:
    • Half non-starchy veggies
    • A palm-size serving of protein
    • A small portion of smart carbs or swap for extra veggies
  • Drink water first. Keep a bottle near you.
  • Sleep 7–8 hours. Poor sleep raises blood sugar.
  • Lower stress in simple ways:
    • 5 deep breaths
    • 10-minute walk
    • Short stretch before bed
  • Make it easy:
    • Set shoes by the door for post-meal walks.
    • Prep 2–3 go-to meals you like.
    • Keep a veggie and a protein ready to grab.
  • Do a quick self-check each week:
    • What went well?
    • What was hard?
    • What is one tiny change I will try next week?
Signs you’re beating inertia
  • Your post-meal numbers trend down.
  • A1C drops over 3–6 months.
  • You need fewer meds, or lower doses.
  • You feel more energy and move more without forcing it.
  • Your plan feels doable most days.
Real talk moments we shared
  • “It’s not laziness. It’s Clinical Inertia.”
  • “We can’t fix it all in 16 minutes.”
  • “Your beta cells are urgent. Early action protects them.”
  • “Ignore your health, and it will go away.”
  • “Remission is real. Behavior change works.”
Who this episode helps
  • Newly diagnosed with type 2 diabetes
  • “Stuck” at the same A1C or creeping higher
  • On more meds and want a different path
  • Clinicians who want plain-language ways to support patients
Resources and next steps
  • Free: Keep listening to the Diabetes Podcast for step-by-step help.
  • Fast-track help: EmpoweredDiabetes.com for a guided plan and support.
  • Share: Someone you love is dealing with this. Send this episode to them.
Call to action
  • Subscribe, rate, and review the show so more people can find help.
  • Try one step today. Walk two minutes after your next meal.
  • If you’re ready for a plan and a partner, visit EmpoweredDiabetes.com.
Disclaimer

This podcast is for education, not medical advice. Work with your healthcare team before changing your meds, diet, or exercise.

You deserve more than a rushed visit. You deserve a plan, a partner, and real progress. Take courage. You can do this—and we can help.

 

Disclaimer:

The information in this podcast is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment, and it does not replace a one-on-one relationship with your physician or qualified healthcare professional. Always talk with your doctor, pharmacist, or care team before starting, stopping, or changing any medication, supplement, exercise plan, or nutrition plan—especially if you have diabetes, prediabetes, heart, liver, or kidney conditions, or take prescription drugs like metformin or insulin.

Results vary from person to person. Examples, statistics, or studies are shared to educate, not to promise outcomes. Any discussion of medications, dosing, or side effects is general in nature and may not be appropriate for your specific situation. Do not ignore professional medical advice or delay seeking it because of something you read or heard here. If you think you are experiencing an emergency or severe side effects (such as persistent vomiting, severe diarrhea, signs of dehydration, allergic reaction, or symptoms of lactic acidosis), call your local emergency number or seek urgent care right away.

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