Can Navigation Programs Help Black Americans With Diabetic Kidney Disease?

What Was Studied and Why It Matters

Diabetic kidney disease (DKD) — kidney damage caused by diabetes — is the number one reason Americans end up on dialysis or need a kidney transplant. But the burden is not shared equally. African Americans are nearly four times more likely than non-Hispanic white Americans to reach that critical stage of kidney failure known as end-stage kidney disease (ESKD).

Researchers from the Medical College of Wisconsin wanted to understand whether a structured "basic needs navigation" program could help close that gap. The idea: many African Americans with DKD face layered social challenges — things like food insecurity, housing instability, transportation barriers, and limited access to healthcare — that make managing a complex condition like DKD much harder. This pilot clinical trial, currently underway, is testing whether tackling those social challenges directly leads to better health outcomes.

How the Study Works

Fifty African American adults with DKD and uncontrolled diabetes (defined as an HbA1c of 8% or higher) are being enrolled. All participants must be experiencing at least one social adversity. They are randomly assigned to one of two groups:

• Basic Needs Navigation Group: Participants receive help connecting to community resources, along with diabetes education and lifestyle coaching.
• Enhanced Usual Care Group: Participants receive standard medical care with some additional educational support.

The three-year trial is primarily measuring whether the program is practical — can researchers recruit enough participants, keep them engaged, and retain them through the study? These are critical first steps before a larger, definitive trial can be launched.

What This Means for Real Patients

This research recognizes something many patients and caregivers already know: managing diabetes and kidney disease is not just a medical challenge. When you are worried about your next meal, getting to a doctor's appointment, or keeping the lights on, blood sugar logs and medication schedules can feel impossible to prioritize.

A navigation program acts like a personal guide — someone who helps you find food assistance programs, transportation services, or financial aid — so that the non-medical barriers to staying healthy are reduced. Combined with education on diet, medications, and monitoring, this kind of wraparound support could make a real difference.

For patients already managing their supplies — whether glucose meters, test strips, or continuous glucose monitors — having a reliable source matters too. Organizations like MDS Diabetes help ensure patients have consistent access to the diabetes supplies they need, which is one less barrier to worry about.

Bottom Line

• African Americans face a dramatically higher risk of severe kidney disease related to diabetes.
• Social challenges like poverty, housing, and food access make managing diabetic kidney disease harder.
• This pilot trial is testing whether a "navigation" program that connects patients to social services — alongside education and coaching — can improve outcomes.
• If successful, this small study could lead to a large-scale program that meaningfully reduces kidney disease disparities in Black communities.
• Results are not yet available, but the approach represents a promising, whole-person model of diabetes care.