What’s New In Diabetes Research and Clinical Practice?
Diabetes is a devastating disease. The US News and World Report found it was the eighth-leading cause of death in 2020 and 2021, and it’s responsible for serious complications that include stroke, blindness, kidney failure and limb amputation. As it continues to become more prevalent, diabetes research and clinical practice is expanding as well.
While diabetes impacts people of all racial, ethnic, and socioeconomic backgrounds, it’s more prevalent among certain groups who may or may not be well-represented in clinical trials.
Here’s a closer look at how diabetes affects people of different backgrounds, what new treatment options are being studied, and why people with diabetes should consider participating in clinical trials to contribute to future advancements and increase diversity.
What are the current statistics on diabetes in America?
The Centers for Disease Control estimates more than 130 million Americans, or nearly 39% of the population, have diabetes or prediabetes, according to its latest report. Only about a fourth have been diagnosed, while many more are living with diabetes or meet the criteria for being prediabetic without knowing it. As many as 70% of people with prediabetes will eventually develop diabetes, according to the American Diabetes Association.
The Diabetes Research Foundation also notes more than 283,000 children and young adults under 20 had diagnosed diabetes in 2019, with the majority being diagnosed with type 1, or insulin-dependent diabetes.
According to the CDC, the prevalence of diagnosed diabetes is highest among American Indian/Alaska Native adults (14.5%), followed by non-Hispanic Black adults (12.1%), Hispanic adults (11.8%), non-Hispanic Asian adults (9.2%) compared to non-Hispanic White adults (7.4%).
The CDC also cites data from a National Health Interview survey that found the highest prevalence of diabetes among adults with the lowest income levels and the lowest levels of education.
What are the focus areas of recent diabetes research?
Diabetes research and treatments differ depending on the type. Because type 1 diabetes is an autoimmune disease in which the body attacks insulin-producing cells in the pancreas, current treatments are often disruptive, involving frequent blood sugar monitoring and using insulin injections or pumps to regulate blood sugar. The FDA recently approved Lantidra, an infusion and the first treatment made from donor pancreatic cells, for the treatment of type 1 diabetes.
Type 2 diabetes is a metabolic disorder in which the body becomes resistant to insulin or doesn’t produce enough. Much of the treatment today involves managing blood sugar levels with lifestyle changes, including eating a low sugar diet. Some people may need insulin injection or other medications.
There are nearly 800 clinical studies for diabetes currently underway in the United States, according to ClinicalTrials.gov. They cover a wide range of potential treatments, including:
To treat type 1 diabetes, researchers are exploring immunotherapy to reset the immune response. Clinical trials are ongoing for several immunotherapeutic drugs, including an immunotherapy vaccine. Beta cell replacement therapy is one potential area of research for people with type 1 diabetes, though the research has been limited so far.
New oral medications
While the FDA has approved some oral medications such as metformin, which reduces glucose produced by the liver, it has issued warnings against using it for patients with reduced kidney function. Other medications used to treat diabetes, such as dipeptidyl-peptidase 4 (DDP-4) inhibitors, have side effects, including severe joint pain.
Glucagon-like peptide 1 (GLP-1) receptor agonists, which slow digestion and stimulate insulin production, are effective in helping people with type 2 diabetes achieve lower A1C levels (a measure of average blood sugar over time), according to the American Diabetes Association. The FDA has approved several of these medications, including one of them, Rybelsus, in a pill form.
Recent clinical trials have also studied using sodium-glucose cotransporter 2 (SGLT-2) inhibitors for the treatment of type 2 diabetes. Initial research has shown they can reduce heart failure and chronic kidney disease while also supporting weight loss, but additional clinical trials are ongoing.
Scientists from Cambridge University recently conducted a clinical trial using an artificial pancreas, a system consisting of an insulin pump and glucose monitor, on patients with type 2 diabetes. Though the study was limited to just 26 participants, patients who used the system stayed within their target glucose range for eight hours longer than the control group.
Why should diabetic patients consider clinical trials?
Managing diabetes is both difficult and costly. People with diabetes are more likely to be hospitalized for health problems directly or indirectly related to the disease and require prescription medications. They also have medical expenses that are more than twice as high as someone without diabetes, spending an average of over $16,700 a year, according to the American Diabetes Association.
Participating in a clinical trial can be a more cost-effective care option. Patients receive at least the standard of care and receive ongoing monitoring in addition to other resources to treat diabetes and improve their health.
They also have an opportunity to try a new treatment that could be more effective than what they’ve been prescribed while contributing to advancements that could benefit many others.
For any new treatment to be truly safe and effective, it needs to be tested on a diverse population that represents the people who will benefit from it. Yet a cross-sectional study of all clinical trials published in major medical journals found approximately 90% of all US trial participants were white in 2019. Other groups, including Black and Native American populations, had much lower rates of participation, despite having a greater prevalence of certain diseases, including diabetes.
At M&B Sciences, we are committed to helping sponsors recruit more diverse patient populations to improve health equity. Our expertise in spatial epidemiology, as well as our proprietary technology and extensive partnerships with diverse community groups, makes us uniquely qualified to identify and recruit specific populations.
Our Neighborhood Trials mobile app also makes it easier than ever for patients to find a trial close to home.
To learn more about how we can help your clinical trial, schedule a consultation today.