Research shows differences in the effectiveness of diabetes medications in the black population

New research analyzing the effects of two drugs used to treat type 2 diabetes suggests that the effects consistently show cardiovascular and renal benefits in the black population. Cardiovascular disease is the leading cause of severe illness and death associated with type 2 diabetes. Kidney disease is also a common complication of type 2 diabetes.

Drugs called sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) and glucogen-like peptide 1 receptor agonists (GLP1-RAs) are some of the newer treatments prescribed to lower blood sugar levels in people with type 2 diabetes.

The research results, published in Journal of the Royal Society of Medicineshow that SGLT2-Is and GLP1-RAs have beneficial effects on blood pressure, weight control and kidney function in white and Asian populations and significantly reduce the risk of serious heart problems and kidney disease. However, research provides no evidence of these beneficial effects in the black population.

Researchers at the University of Leicester Diabetes Research Centre analyzed the results of 14 randomized controlled trials of SGLT2-Is and GLP1-RAs that described cardiovascular and renal outcomes by race, ethnicity, and region.

Lead researcher Professor Samuel Seidu, Professor of Diabetes in Primary Care and Cardiometabolic Medicine at the University of Leicester, said: “Given the well-documented evidence that black and other ethnic minorities develop type 2 diabetes more frequently and at younger ages, the persistent lack of benefit we have observed in the black population is worrying.”

“To minimize racial and ethnic disparities in the cardiovascular and renal complications of type 2 diabetes, targeted improvements in access to care and treatment for those most at risk are needed.”

The researchers suggest that there are many factors that may have contributed to the lack of evidence of positive effects for black and other non-white populations. The low statistical power due to the small sample size of these populations may be partly responsible.

“It is clear from the available data that some racial/ethnic groups, such as the black population, were underrepresented in all studies included.”

Professor Samuel Seidu, Professor of Diabetes Primary Care and Cardiometabolic Medicine, University of Leicester

The participation rates in the studies ranged from 66.6% to 93.2% in the white population, 1.2% to 21.6% in the Asian population, and 2.4% to 8.3% in the black population.

However, the researchers believe that, given the consistent significant lack of positive effects in most of the results for the black population, other factors may also play a role.

“Whether the differences are due to issues with underrepresentation of the black population and low statistical power or due to racial-ethnic differences in the way the body and these drugs interact needs further investigation,” Professor Seidu said. “It is therefore important that doctors who prescribe drugs do not rush to deny these newer treatments to the black population based on this research.”