The newest diabetes medications to hit the market in the United States may not have adequately been trialed on Black people, a study suggests.
Newer diabetes medications, which mostly belong to two classes of drugs called sodium-glucose co-transporter two inhibitors (SGLT2s) and glucogen-like peptide one receptor agonists (GLP-1s) — which includes Ozempic, Wegovy and Mounjaro — are designed to lower blood glucose levels in people with type-2 diabetes.
Additionally, the drugs can positively impact blood pressure levels, help manage weight and significantly reduce the risk of severe heart problems and kidney disease.
However, a British research team who published their findings last week in the Journal of the Royal Society of Medicine, found that while white and Asian people with type-2 diabetes are able to benefit from the drug, there isn’t reliable data to show the same for Black people who take these medications.
Black people made up less than 10% of clinical trials analyzed by the researchers, a low figure when compared to their overall diabetes burden in the U.S.
In the U.S., Black Americans are 60% more likely to be diagnosed with diabetes than their white counterparts, and twice as likely to die from complications related to the disease.
They’re also twice as likely to die or have their legs amputated from uncontrolled diabetes than their white counterparts, according to the American Heart Association. Black people are also three times more likely to develop serious complications from kidney disease.
“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,” lead researcher Samuel Seidu, M.D., a professor in primary care diabetes at the University of Leicester, said in a statement.
To find out why, researchers examined 14 different studies from across the world that focus on SGLT2 and GLP-1 medications and the drugs’ effect on heart and kidney function based on race, ethnicity and region.
They found that in most studies, white people made up the largest number of enrollments with anywhere from 66% to 93% of all enrolled participants. Asian people ranged from 1% to 21% of study participants. On the other hand, Black people were 2% to 8% of trial participants.
“It is quite clear from the current data that some racial/ethnic groups such as Black populations were underrepresented in all the included trials,” Dr. Seidu said.
However, other factors may also fuel the disparities, such as barriers to access to clinical trials, institutional hurdles and low access to medical care and treatment among Black individuals. Medical mistrust in the healthcare system due to long-standing racism may also deter diabetes screenings and care among Black people, the researchers say.
To curb the growing problem, Dr. Seidu notes that the disparities need to be addressed head-on.
“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,” he said.
For this, he called for more research on diabetes treatment, how drugs affect Black people, and improving access to drug trials. In the meantime, he says healthcare providers need to continue treating Black people with appropriate treatments.
“It is therefore important that prescribers don’t hasten to deny these newer treatments to Black populations on the back of this research,” Dr. Seidu said.