• Posted September 22, 2023

Newer Diabetes Meds Might Not Work as Well in Black Patients

New research suggests some newer diabetes treatments may not be as beneficial for Black patients, after earlier drug trials included small numbers of non-white people.

Whether the medications -- called sodium-glucose co-transporter 2 inhibitors (SGLT2-Is) and glucogen-like peptide 1 receptor agonists (GLP1-Ras) -- actually have less benefit for Black patients or whether the small sample size was unreliable isn't clear yet.

"Given the well-documented evidence that Black and other ethnic minority populations are more likely to develop type 2 diabetes and at a younger age, the consistent lack of benefits we observed among Black populations is concerning," said lead researcher Samuel Seidu, a professor in primary care diabetes and cardio-metabolic medicine at the University of Leicester in the U.K.

"Minimizing racial and ethnic variations in the cardiovascular and renal complications of type 2 diabetes requires targeted improved access to care and treatment for those most at risk," Seidu said in a university news release.

The new analysis of 14 randomized, controlled trials of these drugs showed a consistent lack of heart and kidney benefits in Black populations.

Heart disease is the leading cause of severe illness and death associated with type 2 diabetes. Kidney disease is another common complication.

For white and Asian populations, SGLT2-Is and GLP1-RAs had beneficial effects on blood pressure, weight control and kidney function. They significantly reduced the risk of severe heart problems and kidney disease.

The authors found no evidence of these beneficial effects in Black populations.

The findings were published Sept. 22 in the Journal of the Royal Society of Medicine.

“It is quite clear from the current data that some racial/ethnic groups such as Black populations were underrepresented in all the included trials,” Seidu said.

Participation in trials ranged from 66.6% to 93.2% white; 1.2% to 21.6% Asian; and 2.4% to 8.3% Black.

Researchers said the consistent and significant lack of benefit for Black populations suggests other factors may be at play.

"Whether the differences are due to issues with under-representation of Black populations and low statistical power, or to racial/ethnic variations in the way the body and these drugs interact with each other needs further investigation," Seidu said. “It is therefore important that prescribers don't hasten to deny these newer treatments to Black populations on the back of this research.”

More information

The American Diabetes Association has more on medications for the condition.

SOURCE: Sage, news release, Sept. 21, 2023