Heart disease-protective diabetes drug is not used equitably

A medication typically used for treating diabetes, glucagon-like peptide-1 receptor agonists (GLP-1 RA), could also be used to prevent cardiovascular disease and major cardiovascular events, but a new study shows inequities in its use based on race, ethnicity, and socioeconomic status. Looking at four years of data, researchers from the Perelman School of Medicine saw that the odds of using this medication were as much as 41% lower for some groups that are historically underserved by health care. This research is published in JAMA Health Forum.

Doctor wearing a mask checks the blood pressure of a patient also wearing a mask.

“Cardiovascular disease is the leading cause of death among patients with type 2 diabetes and GLP-1 receptor agonists have been shown to reduce major adverse cardiovascular events,” says the study’s lead author, Lauren Eberly, a clinical fellow in cardiovascular disease. “Our study demonstrated significant inequities in use among Black, Latinx, and Asian patients, as well as patients of lower economic status being less likely to be prescribed this therapy. Given well-documented racial disparities in the burden of diabetes and cardiovascular disease, we feel that the differences in utilization of this therapy must be addressed to prevent worsening inequitable outcomes.”

GLP-1 RAs are prescribed for diabetes because they help restore blood sugar balance in the body, activating receptors for the GLP-1 hormone in the pancreas to boost insulin while also tamping down the mechanisms that release blood sugar. In addition to improved blood sugar control, the medication helps patients manage their weight. Recent studies have added a new facet to this medication’s benefits: reductions in heart health issues, especially those related to increased blood pressure. The American Diabetes Association recommends the use of GLP-1 RAs by patients with atherosclerotic cardiovascular disease, heart diseases caused by buildup and blockages in arteries.

Knowing that patients who are Black have been shown to have higher prevalence of diabetes and heart disease mortality risk, Eberly and her fellow researchers—including the study’s senior author, Srinath Adusumalli, an assistant professor of clinical medicine in cardiology and assistant program director of the cardiovascular disease fellowship—examined data on GLP-1 RA prescription and use under the lens of race, ethnicity, and economic status. The goal was to shed light on whether uptake of this potentially lifesaving medication has been equitable.

This story is by Frank Otto. Read more at Penn Medicine News.