Delivering standardized care may reduce racial disparities in diabetes complications

May 24, 2018, American Society of Nephrology

Although kidney problems related to type 2 diabetes disproportionately affect blacks, when black and white individuals received comparable diabetes care within the context of a clinical trial, black race was not associated with faster development or progression of chronic kidney disease (CKD). The findings, which appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), suggest that delivering standardized care to patients with type 2 diabetes may reduce racial disparities in diabetes-associated complications.

Among with type 2 , blacks have a disproportionate burden of diabetes-related complications. Also, among diabetic patients with , the risk of progressing to kidney failure is two- to three-fold higher in blacks compared with whites. It is unclear whether these disparities are due to differences in biologic factors or differences in medical care.

To investigate, a team led by Claire Gerber, Ph.D., MPH and Tamara Isakova, MD, MMSc (Feinberg School of Medicine, Northwestern University) analyzed information on 1937 black and 6372 white patients with type 2 diabetes who were participating in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. All patients received comparable type 2 diabetes care.

During a median follow-up period of 4 to 5 years, black race was not associated with accelerated kidney function decline, and fewer black participants developed CKD.

"In spite of blacks having more risk factors for adverse kidney outcomes in our study, we found that comprehensive type 2 diabetes care within the context of a clinical trial eradicated in the development and progression of CKD," said Dr. Gerber. Dr. Isakova noted that the findings are similar to recent results from the Indian Health Service first Diabetes Standards of Care implementation effort that delivered comprehensive diabetes care to American Indians and Alaska Natives. "Taken together, our results and the findings from the Indian Health Service demonstrate that delivery of comparable diabetes care has the potential to achieve equitable health outcomes for all patients with diabetes."

In an accompanying editorial, Katherine Tuttle, MD, FASN, FACP, FNKF (Providence Medical Research Center, in Spokane) calls for action. "Optimal care for diabetes and CKD can, and must, be achieved by strategic focus, for example, by increasing opportunity for clinical trial participation and through broad-based population management," she wrote. "The time is now to lead the way forward to better health for all without distinction."

Explore further: Women with pregnancy-related diabetes may be at risk for chronic kidney disease

More information: Claire Gerber et al, Incidence and Progression of Chronic Kidney Disease in Black and White Individuals with Type 2 Diabetes, Clinical Journal of the American Society of Nephrology (2018). DOI: 10.2215/CJN.11871017

Related Stories

Women with pregnancy-related diabetes may be at risk for chronic kidney disease

May 21, 2018
Gestational diabetes may predispose women to early-stage kidney damage, a precursor to chronic kidney disease, according to a study by researchers at the National Institutes of Health and other institutions. The study appears ...

Health-care system factors may have less influence on kidney-related racial disparities

July 11, 2013
Among patients with kidney disease who received specialized pre-dialysis care in a universal healthcare system, blacks experienced faster disease progression than whites, according to a study appearing in an upcoming issue ...

Native Americans make progress against diabetes complication

January 10, 2017
(HealthDay)—Diabetes-related kidney failure among Native American adults fell by more than half over almost 20 years, a U.S. Centers for Disease Control and Prevention report shows.

More years lost for whites versus South Asians, blacks with T2DM

December 27, 2016
(HealthDay)—Whites with type 2 diabetes have more life years lost than South Asians or blacks, according to a study published online Dec. 20 in Diabetes Care.

Dietary potassium may help prevent kidney and heart problems in diabetics

November 12, 2015
Diets rich in potassium may help protect the heart and kidney health of patients with type 2 diabetes, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Major depression linked with nearly twice the risk of kidney failure in diabetics

March 27, 2014
Major depression may increase diabetes patients' risk of developing kidney failure, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). Additional studies ...

Recommended for you

Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes

December 11, 2018
Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes.

Millions of low-risk people with diabetes may be testing their blood sugar too often

December 10, 2018
For people with Type 2 diabetes, the task of testing their blood sugar with a fingertip prick and a drop of blood on a special strip of paper becomes part of everyday life.

Very low calorie diets trialled by NHS to tackle diabetes

December 7, 2018
Hundreds of thousands of people will receive NHS help to battle obesity and type 2 diabetes under radical action set out by Simon Stevens, Chief Executive of NHS England.

New therapeutic avenue for type 2 diabetes

December 6, 2018
Restoring the action of insulin is one of the keys to fighting type 2 diabetes. Researchers from Inserm led by Dominique Langin at the Institute of Cardiovascular and Metabolic Diseases (Inserm/Université de Toulouse) are ...

Subtype of immune B cells can delay type 1 diabetes onset in mice

December 6, 2018
A team of researchers at Baylor College of Medicine and the University of Michigan Medical School reports today in the JCI Insight that a subset of immune B cells, known as CD19+IgM+ B cells, can delay the onset of type 1 ...

Is the pancreas regeneration debate settled? An original theory renewed

December 5, 2018
A contentious debate among diabetes researchers has surrounded the regeneration of pancreatic insulin-producing cells: not if these cells regenerate, but rather how.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.