John A. Burns School of Medicine at University of Hawaii at Manoa, Hawaii

— -- Aloha. My name is Dr. Kalani Brady. I am an internal medicine physician at the University of Hawaii at Manoa, John A. Burns School of Medicine, Department of Native Hawaiian Health, in Honolulu. At the University, we have been involved in federally funded diabetes research for more than a decade.

Because of Hawaii's unique geographical location and large stable population of Native Hawaiians, Asian Americans, and Pacific Islanders, more recent research in diabetes has centered on health disparities that exist in these diverse ethnic groups. Native Hawaiians, Filipinos, and Japanese are all 2 times more likely to have diabetes than Caucasians in Hawaii. More alarming are the death rates for diabetes in Native Hawaiians who are 5.7 times more likely to have diabetes listed as an underlying or contributing cause of death than Caucasians according to data collected through the Behavioral Risk Factor Surveillance System.

Drs. Richard Arakaki and Marjorie Mau, both endocrinologists with the University, have served as lead investigators for a multi-centered randomized control trial on the prevention of diabetes (The Diabetes Prevention Program funded by the National Institutes of Health). The study was ended early because it was found that a modest lifestyle intervention was more effective at preventing diabetes in those at high risk compared to the other two arms (drug therapy and control).

Because of the persistent disparities in health status endured by the indigenous people of Hawai'i, Kanaka Maoli, the medical school created an entire department dedicated to the health of Native Hawaiians and other Pacific Island Peoples. Diabetes is one of many focal areas for the department and clinical efforts are based on community engagement.

We are training community health workers statewide on basic facts about diabetes. We have a research project aimed at weight loss and weight maintenance through a behavioral lifestyle intervention for at-risk individuals. And several pilot studies by community investigators aim to better understand the effects of diabetes in their communities.