Research Projects - Diabetes

Patient getting a blood testDiabetes is a major health concern in the Pacific.  The following projects focus on this important area.


Diabetes and Obesity: Associations with Cognition, Neuropathology, and Longevity


This project will use already-collected information from the Honolulu-Asia Aging Study to understand better how obesity and diabetes affect the risk of cognitive decline in the elderly and length of life.  It will also study how these factors affect the presence at autopsy of brain lesions related to dementia.  This project may allow us to identify which groups of persons with diabetes may be more likely to have adverse outcomes, which may eventually allow for early identification and treatment of higher risk groups.


Glycemia Reduction Approaches in Diabetes (GRADE)


PHREI is now enrolling volunteers to take part in the GRADE study to compare the long term benefits and risks of 4 widely used diabetes drugs in combination with metformin, the most common first-time medication for treating type 2 diabetes.  If metformin is not enough to help manage type 2 diabetes, a person’s doctor may add one of several other drugs to lower glucose (blood sugar).  But while short-term studies have shown the efficacy of different drugs when used with metformin, there have been no long-term studies of which combination works best and has fewer side effects.  The study will compare drug effects on glucose levels, adverse effects, diabetes complications, and quality of life over an average of nearly 5 years.  Participants will be seen at the VA outpatient clinic in Honolulu, Hawaii.  PHREI, in collaboration with the VA Pacific Islands Health Care System, is one of 37 clinical sites in the US taking part in the GRADE study funded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. 

Are you interested in participating in the study?   See our appearance on Hawaii News Now for more information (click on the link below).



Reducing Cost-Related Medication Nonadherence in Persons with Diabetes

In a statewide physician survey, 9 in 10 physicians said difficulty knowing drug costs prevented them from helping patients with medication costs.  Non-adherence to medication regimens is an important and persistent public health challenge in patients with chronic diseases and cost-related mediation non-adherence is an important area of research. 

This study will examine the effectiveness of a hardcopy/web-based physician Prescribing Guide (PG) developed by the investigator in improving medication adherence and lowering medication costs for patients with diabetes by helping physicians easily know drug costs when prescribing.  The PG summarizes multiple formularies in a standard format, highlights widely covered drugs, gives retail prices from discount pharmacies, and has links to assistance programs. Hawaii’s BlueCross BlueShield - HMSA medical insurance provider and the University of Hawaii John A. Burns School of Medicine are collaborators on the study.