What Dominates Diabetes Research, Prevention or Drug Therapy?

With all the news about drug therapy, many researchers are beginning to wonder what is being done to stop diabetes from happening in the first place. Studies show, not much.

According to a Duke Medicine study, research for diabetes is far more focused on drug therapy than it is on taking the preventative measures to stop diabetes in its tracks. While also excluding older people and children from gaining better management for the disease.

For the study, almost 2,500 diabetic-related trials registered in the website, ClinicalTrials.gov from the year 2007 to 2010 were analyzed. The findings of the study showed that the current research strides are not so focused on preventing the disease but are more focused on managing through drug therapy. 

“It’s important that clinical trials enroll patients who are representative of populations affected by diabetes and its complications. Our study is just a snapshot in time, but it can serve as a guide for where we need to focus attention and resources.” said Jennifer Green, M.D, associate professor at Duke University School of Medicine and member of the Duke Clinical Research Institute.

Green and her colleagues used data and the clinical trials and colleagues for the study, which showed that out of 2,484 trials that were related to diabetes, 75 percent of them were focused on treatment while only 10 percent focused on preventative measures. For the treatment, 63 percent involved drug therapy and 12 percent involved the introduction of behavioral measures such as diet and exercise.

Green said, “We don’t know what the right ratio of these different types of trials should be, but this is a good starting point for discussion.”

Researchers had also gained evidence that many clinical trials enrolled small numbers of patients into a small amount of sites, or were completed in less than two years or they did not represent a geographically broad mix of patients.

Typically, type 2 diabetes develops in adults and is a greater risk in older adults. However, diabetes is increasing in children and teens as well, even more so for those living in wealthier places.

According to research from the group, older people were excluded from 31 percent of the trials and became the main focus of just one percent of the studies. In addition, only 4 percent of the studies were aimed at children ages 18 and younger.

Green said, “When trials are excluding patients who are older or younger, it’s questionable whether the trial findings can be applied to people in those age groups. We really don’t understand how best to manage disease in these patients — particularly among patients of advanced age. So the exclusion of them from most studies and the small number of trials that specifically enroll older individuals is problematic.”

Researchers also found that a small amount of diabetic trials were designated for the interventions of diabetic complications such as heart attack, stroke and/or death.

“We will see many more such trials in the future, given the recent emphasis on assessing diabetes medications for cardiovascular safety,” Green said.