04 July 2013

Research More Interested In Treatments, Not Prevention


This is the hard part of doing information research for diabetes. Most everything is focused on drug therapy and not prevention. “Research for diabetes is far more focused on drug therapies than preventive measures, and tends to exclude children and older people who have much to gain from better disease management, according to a Duke Medicine study.” The previous quote from this Science Daily article is the problem today. Researchers today are only interested in diabetes patients that are between the ages of 21 to 64, and they discriminate against the young and the elderly.

Jennifer Green, M.D, associate professor at Duke University School of Medicine and member of the Duke Clinical Research Institute was the lead author in this study. Dr. Green states, "It's important that clinical trials enroll patients who are representative of populations affected by diabetes and its complications."

Dr. Green and colleagues analyzed trials from ClinicalTrials.gov and found 2484 trials related to diabetes and from October 2007 to September 2010.

#1. 75% focused on diabetes treatment.
a. 63% involved a drug.
b. 12% were behavioral.

#2. 10% were designed to test a preventive measure.

#3. 15% were not specified.

The researchers found that most clinical trials enrolled small numbers of patients at a small number of sites. Most were completed in less than two years. Most did not represent a geographically broad mix of patients and excluded young patients and elderly patients.

According to the research group, older people were explicitly excluded from 31 percent of trials, and were the main focus of only 1 percent of the studies. Similarly, just 4 percent of diabetes trials were aimed at people ages 18 and younger. The research group also found that only small numbers of diabetes trials were designed to assess the effect of interventions upon events such as heart attack, stroke, 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.

In their conclusion the authors' state, “The majority of diabetes-related trials include small numbers of participants, exclude those at the extremes of age, are of short duration, involve drug therapy rather than preventive or non-drug interventions and do not focus upon significant cardiovascular outcomes. Recently registered diabetes trials may not sufficiently address important diabetes care issues or involve affected populations.”

For those that want the details of the study, it may be found at this link. Then a scroll down the page to this description, “Are current clinical trials in diabetes addressing important issues in diabetes care? by W. C. Lakey, K. Barnard, B. C. Batch, K. Chiswell, A. Tasneem, J. B. Green” At the bottom of the discussion is the link to download the PDF file. This study will eventually scroll off the page. Then you will need to do a search for the article in volume 56, issue 6 and this title - Are current clinical trials in diabetes addressing important issues in diabetes care?
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