A US study has found that when black and white people with type 2 diabetes received the same standard care, being black was not associated with accelerated kidney function decline.
The findings are noteworthy because they suggest that delivering standardised care to those with type 2 diabetes in the US could reduce racial disparities in diabetes-related complications.
In the US population, black men and women have a disproportionate increase in diabetes-related complications. Among those with chronic kidney disease (CKD), the risk of progression to kidney failure is two to three times higher compared with white people.
It is unknown whether this risk is attributable to biological factors or differences in medical care, so researchers from the Feinberg School of Medicine, Northwestern University set about understanding why.
They analysed information from 1,937 black and 6,372 white people with type 2 diabetes, all of whom had participated in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. All the participants had received comparable type 2 diabetes care.
Being black was not associated with accelerated kidney function decline during a follow-up period of 4-5 years, 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 racial disparities in the development and progression of CKD,” said co-lead author Claire Gerber, PhD, MPH.
Co-lead Tamara Isakova, MD, MMSc, noted that the findings are similar to a recent study involving the Indian Health Service where comprehensive diabetes care was delivered to Alaska Natives and American Indians.
Dr Isakova said: “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.”
The study has been published in the Clinical Journal of the American Society of Nephrology.

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