Representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering therapies in Type 2 diabetes

K. Khunti*, S. Bellary, M.A. Karamat, K. Patel, V. Patel, A. Jones, J. Gray, P. Shepherd, W. Hanif,

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Aims : Our aim was to investigate the proportional representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering drugs or strategies in Type 2 diabetes, noting that these are among the most significant pieces of evidence used to formulate the guidelines on which clinical practice is largely based.
Methods : We searched for cardiovascular outcome trials in Type 2 diabetes published before January 2015, and extracted data on the ethnicity of participants. These were compared against expected values for proportional representation of South Asian individuals, based on population data from the USA, from the UK, and globally.
Results : Twelve studies met our inclusion criteria and, of these, eight presented a sufficiently detailed breakdown of participant ethnicity to permit numerical analysis. In general, people of South Asian origin were found to be under-represented in trials compared with UK and global expectations and over-represented compared with US expectations. Among the eight trials for which South Asian representation could be reliably estimated, seven under-represented this group relative to the 11.2% of the UK diabetes population estimated to be South Asian, with the representation in these trials ranging from 0.0% to 10.0%.
Conclusions : Clinicians should exercise caution when generalizing the results of trials to their own practice, with regard to the ethnicity of individuals. Efforts should be made to improve reporting of ethnicity and improve diversity in trial recruitment, although we acknowledge that there are challenges that must be overcome to make this a reality.
Original languageEnglish
Pages (from-to)64-68
Number of pages5
JournalDiabetic Medicine
Volume34
Issue number1
Early online date28 Apr 2016
DOIs
Publication statusPublished - 1 Jan 2017

Bibliographical note

This is the peer reviewed version of the following article: Khunti, K., Bellary, S., Karamat, M. A., Patel, K., Patel, V., Jones, A., ... South Asian Health Foundation (2017). Representation of people of South Asian origin in cardiovascular outcome trials of glucose-lowering therapies in Type 2 diabetes. Diabetic Medicine, 34(1), 64-68, which has been published in final form at http://dx.doi.org/10.1111/dme.13103. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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