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University of California, Irvine Researchers Find Positive Impact of New Medication Practices on Diabetes Management
A groundbreaking study from the University of California, Irvine (UCI), reveals that recent improvements in anti-diabetic medication and management practices have significantly reduced severe complications from Type 2 diabetes in American Indian and Alaska Native (AI/AN) adults. The findings, published in the journal Diabetes, Obesity and Metabolism, highlight a notable reduction in emergency room visits and hospitalizations due to dangerous blood sugar fluctuations, such as hypoglycemia, among this high-risk population.
The study, led by Dr. Luohua Jiang, professor of epidemiology and biostatistics at UCI’s Joe C. Wen School of Population & Public Health, focuses on the role of safer anti-diabetic medications and evolving treatment guidelines. Dr. Jiang and his team, including researchers from the Centers for American Indian and Alaska Native Health, the Colorado School of Public Health, and the Indian Health Service (IHS) Division of Diabetes Treatment and Prevention, analyzed nearly 40,000 adults from 2009 to 2013. They aimed to assess the impacts of recent trends in medication use and diabetes management among AI/AN adults who utilized IHS or Tribal health services.
Their retrospective analysis revealed significant improvements in prescribing practices and a decrease in the use of older medications, such as sulfonylureas and thiazolidinediones (TZDs), which are known to cause severe adverse events like low blood sugar (hypoglycemia). Safer alternatives, including metformin, DPP-4 inhibitors, and newer, less risky insulin subtypes, have become more prevalent in treatment protocols, contributing to fewer incidents of severe low and high blood sugar.
Dr. Jiang emphasized that the success of this intervention is not only tied to improved medication but also to broader changes in healthcare approaches. “Along with increased utilization of relatively safer anti-diabetic medications, we also found that a shift in guidelines towards individualized blood sugar level targets, an increased emphasis on team-based case management, and more education and awareness about interventions for these complications among both healthcare providers and patients, contributed to the decrease in complications,” he said.
The research team utilized data from the IHS Improving Health Care Delivery Data Project, a program designed to monitor and improve health services for AI/AN populations. The study’s findings suggest that a growing focus on individualized care and the adoption of newer, safer therapies have contributed to the better management of diabetes-related complications in underserved communities.
Jiahui Dai, the study’s first author and a doctoral student at UCI’s Wen School of Public Health, explained the significance of these trends: “In response to the heavy burden of diabetes in American Indian and Alaska Native people, these trends reflect a growing focus on individualized care and the adoption of newer and safer therapeutic options among an underserved population.”
This research has important implications for improving diabetes management and health outcomes in underserved communities, emphasizing the value of ongoing surveillance and tailored interventions. By shifting focus to personalized care and safer medication options, healthcare providers can offer better outcomes for patients facing the dual challenges of diabetes and limited access to care.
The study also underscores the importance of continuous efforts to address disparities in healthcare access and improve the effectiveness of treatments for chronic conditions in historically marginalized populations.
Source: Jiahui Dai et al, Trends in Anti‐Diabetic Medication Use, Severe Hyperglycemia, and Severe Hypoglycemia Among American Indian and Alaska Native Peoples, 2009–2013, Diabetes, Obesity and Metabolism (2024). DOI: 10.1111/dom.16021
