Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study

Summary: Background: Among patients with type 2 diabetes, minority racial/ethnic groups have a higher burden of cardiovascular disease, chronic kidney disease, and hypoglycaemia. These groups may especially benefit from newer diabetes medication classes, but high cost may limit access. We examined...

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Autores principales:	Ahmed Elhussein, Andrea Anderson, Michael P Bancks, Mace Coday, William C Knowler, Anne Peters, Elizabeth M Vaughan, Nisa M. Maruthur, Jeanne M Clark, Scott Pilla
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Racial disparities Diabetes care Newer medications Medication initiation Socioeconomic disparities Diabetes outcomes Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/01a4479f381a4bca9b02ba5046ba1039
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spelling	oai:doaj.org-article:01a4479f381a4bca9b02ba5046ba10392021-12-04T04:36:44ZRacial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study2667-193X10.1016/j.lana.2021.100111https://doaj.org/article/01a4479f381a4bca9b02ba5046ba10392022-02-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21001071https://doaj.org/toc/2667-193XSummary: Background: Among patients with type 2 diabetes, minority racial/ethnic groups have a higher burden of cardiovascular disease, chronic kidney disease, and hypoglycaemia. These groups may especially benefit from newer diabetes medication classes, but high cost may limit access. We examined the association of race/ethnicity with the initiation of newer diabetes medications (GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors). Methods: We conducted a secondary analysis of the Look AHEAD (Action for Health in Diabetes) trial including participants with at least one study visit after April 28, 2005. Cox proportional hazards models were used to estimate the association between race/ethnicity and socioeconomic factors with time to initiation of any newer diabetes medication from April 2005 to February 2020. Models were adjusted for demographic and clinical characteristics. Findings: Among 4,892 participants, 63.6%, 15.7%, 12.6%, 5.2%, and 2.9% were White, Black, Hispanic, American Indian or Alaskan Native (AI/AN), or other race/ethnicity, respectively. During a median follow-up of 8.3 years, 2,180 (45.2%) participants were initiated on newer diabetes medications. Race/ethnicity was associated with newer diabetes medication initiation (p=.019). Specifically, initiation was lower among Black (HR 0.81, 95% CI 0.70–0.94) and AI/AN participants (HR 0.51, 95% CI 0.26–0.99). Yearly family income was inversely associated with initiation of newer diabetes medications (HR 0.78, 95% CI 0.62–0.98) comparing the lowest and highest income groups. Findings were mostly driven by GLP-1 receptor agonists. Interpretation: These findings provide evidence of racial/ethnic disparities in the initiation of newer diabetes medications, independent of socioeconomic factors, which may contribute to worse health outcomes. Funding source: NIDDK, NIHAhmed ElhusseinAndrea AndersonMichael P BancksMace CodayWilliam C KnowlerAnne PetersElizabeth M VaughanNisa M. MaruthurJeanne M ClarkScott PillaElsevierarticleRacial disparitiesDiabetes careNewer medicationsMedication initiationSocioeconomic disparitiesDiabetes outcomesPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 6, Iss , Pp 100111- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Racial disparities Diabetes care Newer medications Medication initiation Socioeconomic disparities Diabetes outcomes Public aspects of medicine RA1-1270
spellingShingle	Racial disparities Diabetes care Newer medications Medication initiation Socioeconomic disparities Diabetes outcomes Public aspects of medicine RA1-1270 Ahmed Elhussein Andrea Anderson Michael P Bancks Mace Coday William C Knowler Anne Peters Elizabeth M Vaughan Nisa M. Maruthur Jeanne M Clark Scott Pilla Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
description	Summary: Background: Among patients with type 2 diabetes, minority racial/ethnic groups have a higher burden of cardiovascular disease, chronic kidney disease, and hypoglycaemia. These groups may especially benefit from newer diabetes medication classes, but high cost may limit access. We examined the association of race/ethnicity with the initiation of newer diabetes medications (GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors). Methods: We conducted a secondary analysis of the Look AHEAD (Action for Health in Diabetes) trial including participants with at least one study visit after April 28, 2005. Cox proportional hazards models were used to estimate the association between race/ethnicity and socioeconomic factors with time to initiation of any newer diabetes medication from April 2005 to February 2020. Models were adjusted for demographic and clinical characteristics. Findings: Among 4,892 participants, 63.6%, 15.7%, 12.6%, 5.2%, and 2.9% were White, Black, Hispanic, American Indian or Alaskan Native (AI/AN), or other race/ethnicity, respectively. During a median follow-up of 8.3 years, 2,180 (45.2%) participants were initiated on newer diabetes medications. Race/ethnicity was associated with newer diabetes medication initiation (p=.019). Specifically, initiation was lower among Black (HR 0.81, 95% CI 0.70–0.94) and AI/AN participants (HR 0.51, 95% CI 0.26–0.99). Yearly family income was inversely associated with initiation of newer diabetes medications (HR 0.78, 95% CI 0.62–0.98) comparing the lowest and highest income groups. Findings were mostly driven by GLP-1 receptor agonists. Interpretation: These findings provide evidence of racial/ethnic disparities in the initiation of newer diabetes medications, independent of socioeconomic factors, which may contribute to worse health outcomes. Funding source: NIDDK, NIH
format	article
author	Ahmed Elhussein Andrea Anderson Michael P Bancks Mace Coday William C Knowler Anne Peters Elizabeth M Vaughan Nisa M. Maruthur Jeanne M Clark Scott Pilla
author_facet	Ahmed Elhussein Andrea Anderson Michael P Bancks Mace Coday William C Knowler Anne Peters Elizabeth M Vaughan Nisa M. Maruthur Jeanne M Clark Scott Pilla
author_sort	Ahmed Elhussein
title	Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
title_short	Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
title_full	Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
title_fullStr	Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
title_full_unstemmed	Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study
title_sort	racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the look ahead study
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/01a4479f381a4bca9b02ba5046ba1039
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Racial/ethnic and socioeconomic disparities in the use of newer diabetes medications in the Look AHEAD study

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