Ethnic Minority Inequalities Found in NHS Diabetes Treatment

Nicky Broyd

October 08, 2019

Black and ethnic minority type 2 diabetes patients may be at a disadvantage in getting the latest treatment, according to a study. 

University of Surrey researchers analysed data from the Royal College of General Practitioners Research and Surveillance network covering 49,380 patients registered across 164 GP surgeries in England over 5 years to the end of 2016. The findings are reported in PLOS Medicine .

Diabetes and Ethnicity

Type 2 diabetes risks are known to be higher in some ethnic groups, including black and South Asian patients.

The study found that black patients were:

  • Less likely than white patients to have well-managed HbA1c and to have undergone retinopathy testing

  • 50% less likely than white patients to be prescribed SGLT2 inhibitors, GLP-1 agonists, and other newer medications

  • Less likely to have continuous glucose monitoring (CGM) for glycaemic control

Patients from an Asian background were:

  • 14% less likely than white patients to be prescribed insulin

  • 63% less likely to be prescribed GLP-1 agonists

The study was observational, using retrospectively collected data, and did not control for any regional disparities in diabetes care.

Complications Concerns

The study concludes "disparity in glycaemic control, diabetes-related monitoring, and prescription of newer therapies remains a challenge in diabetes care".

In a news release, lead author Dr Martin Whyte, clinical senior lecturer in metabolic medicine at the University of Surrey, said: "The NHS has been successful in improving the quality of diabetes healthcare; however, inequality in care persists. Diagnosis rates for type 2 diabetes are on the rise and it is important that all patients receive the same high levels of care. If they don't, avoidable medical complications occur that are not only distressing for patients but increase pressures on an already stretched NHS."

Simon de Lusignan, professor of primary care & clinical informatics at the University of Surrey and University of Oxford, added: "It is concerning that such an inequality has been identified. Cost and accessibility may be limiting factors for screening and it is important that GPs stress to patients how crucial monitoring is for their long-term health."

This study was undertaken as part of a research partnership between the University of Surrey and Eli Lilly and Company Limited.

Disparities in glycaemic control, monitoring and treatment of type 2 diabetes in England: a retrospective cohort analysis. PLOS Medicine. Published: October 7th 2019. https://doi.org/10.1371/journal.pmed.1002942

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