Black and Asian diabetes patients ‘less likely to be prescribed’ potentially life-saving medication

Black and Asian people living in the UK with type 2 diabetes may be less likely to be prescribed statins, a new study indicates.

People of South Asian and African/African Caribbean ethnicity are more likely than white people to develop type 2 diabetes, as well as cardiovascular disease complications of diabetes such as heart attacks and strokes.

Despite this, a study published in PLOS Medicine found that Black people with type 2 diabetes were 24 per cent, and people of South Asian ethnicity 9 per cent, less likely to receive guideline indicated statins - medication lowers blood cholesterol and reduces cardiovascular complications in people with diabetes.

Type 2 diabetes is a strong risk factor for cardiovascular disease, linked to 17.9 million deaths worldwide per year, 80 per cent of which are due to heart attacks and stroke, researchers say.

Lead author, Sophie Eastwood of University College London, said: “Statins lower cholesterol and are a crucial way of reducing risks of heart attack and stroke in people with type 2 diabetes.

“We estimated that by abolishing ethnic differences in statin prescribing, up to 12,600 heart attacks and strokes could be prevented in people currently affected by type 2 diabetes in the UK.”

The authors say the research was limited as they were unable to identify specific reasons for the inequity in statin prescribing across different ethnicities, claiming that additional investigation is required to establish the reasons behind this disparity.

Researchers accessed a database of 12 million anonymised primary care records from 836 practices in the UK in order to investigate ethnic differences in guideline-indicated statin prescribing for people with type 2 diabetes

They identified 31,039 cases of type 2 diabetes diagnosed between 2006 and 2019.

The researchers then compared rates of statin initiation for people of European, South Asian and African/African Caribbean ethnicity.

They adjusted for differences in socio-demographics, healthcare usage, and cardiovascular risk factors or co-morbidity across the three groups.

“By equalising statin initiation rates between people of South Asian or African/African Caribbean ethnicity and those of European ethnicity, up to an additional 12,600 atherosclerotic cardiovascular disease (ASCVD) events in people with type 2 diabetes could be prevented,” the authors found.

“Therefore, further research must urgently seek explanations for under-prescribing of statins, particularly in African/African Caribbean people.

“If our findings are corroborated, a nationwide strategy for identifying prescribing inequities and providing targeted education and prescribing interventions, followed by re-audit until equitability is achieved, is imperative and could lead to the prevention of substantial cardiovascular morbidity.”

Diabetes patients face a heightened risk of death from Covid-19 and it stands to reason that this would be further elevated in the absence of medication that helps to manage the condition.

Almost one in three people who died from the virus in hospital in England also had diabetes, according to NHS research, with people with type 2 were at twice the risk.

Throughout the pandemic, the rate of death involving Covid-19 has been highest for the Black African group, followed by the Bangladeshi, Black Caribbean and Pakistani ethnic groups than the wider population.

The causes behind these ethnic disparities in coronavirus outcomes include structural racism and social determinants of health such as poverty, overcrowded housing and higher burden of comorbidities such as cardiovascular disease and diabetes, a Public Health England review concluded last June.