New research has revealed significant disparities in the effectiveness of two major drugs used to treat type 2 diabetes, showing that Black populations do not experience the same cardiovascular and renal benefits as their White and Asian counterparts. Cardiovascular disease is the leading cause of severe complications and death in type 2 diabetes patients, with renal disease also posing a common risk.
The study focuses on sodium-glucose co-transporter 2 inhibitors (SGLT2-Is) and glucagon-like peptide 1 receptor agonists (GLP1-RAs), newer medications designed to lower blood sugar levels in individuals with type 2 diabetes. While these drugs show promising effects in reducing blood pressure, aiding weight control, and enhancing kidney function in White and Asian patients, the same benefits were not observed in Black populations.
The research, conducted by the Diabetes Research Centre at the University of Leicester and published in the Journal of the Royal Society of Medicine, analyzed 14 randomized controlled trials, looking at the cardiovascular and renal outcomes of SGLT2-Is and GLP1-RAs across different racial and ethnic groups.
Lead researcher, Professor Samuel Seidu, a specialist in Primary Care Diabetes and Cardio-metabolic Medicine at the University of Leicester, expressed concern over these findings. “There is substantial evidence showing that Black and ethnic minority populations are at a higher risk of developing type 2 diabetes at younger ages,” said Seidu. “Yet, the lack of beneficial effects seen in Black populations from these treatments is alarming.”
The researchers highlighted the urgent need for targeted healthcare interventions that address racial and ethnic disparities, particularly in the cardiovascular and renal complications associated with type 2 diabetes.
One potential explanation for the lack of observed benefits in Black populations is the underrepresentation of non-White participants in clinical trials. The study revealed that trial enrolment ranged from 66.6% to 93.2% for White participants, compared to just 2.4% to 8.3% for Black participants, with Asian populations also underrepresented at 1.2% to 21.6%.
Professor Seidu emphasized that while low statistical power due to small sample sizes might explain part of the disparity, other factors could be involved. “Whether these differences are due to the underrepresentation of Black populations or to variations in how different racial groups respond to these drugs requires further research,” Seidu explained.
Despite the findings, Seidu cautioned against making swift clinical decisions. “It’s important that healthcare providers do not rush to withhold these treatments from Black populations based solely on these results,” he added. Further investigation is essential to understand the underlying causes and to develop more effective treatments for all ethnic groups.
The study’s findings underscore the need for greater diversity in clinical trials to ensure that treatments are effective across all populations and highlight the broader issue of racial disparities in healthcare access and treatment outcomes.
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