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Experts Look at Diabetes Epidemic: Scientists Hope to Explain Why Disease so Prevalent in Valley

Posted on: Monday, 6 March 2006, 12:01 CST

By Melissa Mcever, Valley Morning Star, Harlingen, Texas

Mar. 6--RIO GRANDE CITY -- Leo Lopez has type II diabetes. So do his sister, his wife, his mother and his aunts and uncles.

In Starr County, where 59-year-old Lopez grew up, the disease almost has become a rite of passage: more than half of the population likely has it, and the numbers continue to grow.

Lopez and his family members are all participants in a long-term diabetes study that is looking for answers to this region-wide epidemic.

Researchers in the Starr County Health Studies program hope to learn exactly why Starr County residents like Lopez, and indeed all Rio Grande Valley residents, are facing higher and higher rates of diabetes. They want to go beyond the surface, to understand the genetic reasons why Mexican-American families in particular seem more susceptible to the disease.

Their research already has yielded scores of new findings on diabetes in Mexican Americans, shedding light on the prevalence of diabetes in the region, related conditions, genetic factors and the impact of education. Today, the researchers continue to dig, and say they won't stop anytime soon.

"We talk about leaving no genetic stone unturned," said Craig Hanis, a genetics professor at the University of Texas Health Science Center at Houston and one of the program's founders. "I'm optimistic that we'll be able to understand the genes involved (in diabetes) ... even if we can just prevent or delay the onset of diabetes, even by two or three years, it would have a huge impact financially, on families, on everyone."

Hanis first became interested in studying diabetes in Starr County when he learned that the county had the highest diabetes-mortality rate in Texas. Doctors told him they were overwhelmed with diabetes cases, and that the situation was similar throughout the Valley.

He and other researchers decided that Starr County was an ideal setting for a long-term study because of its stable families and small size, making it easier to track whole families and get a representative sample of the community.

In one of the researchers' first studies, they found that the diabetes rate among Mexican Americans in Starr County was up to five times higher than the general population's. The study was one of the first to establish that Mexican Americans face a higher diabetes risk.

Today, the Centers for Disease Control and Prevention estimates that Mexican Americans are 1.7 times more likely than the general population to have diabetes. CDC officials aren't sure of the cause, said Rachel Ciccarone, health communications specialist for the CDC.

That's exactly what Starr County researchers hope to discover in their recent studies.

In 1996, Hanis and other researchers identified one of the genes involved in type II diabetes. The researchers now are trying to identify and study others.

"It took us 20 years to identify (the gene). I don't think it will take 20 years for the next one," Hanis said. "They will yield their secrets sooner because of technology."

Starr County's studies are funded by the National Institutes of Health, the National Institute of Diabetes and Digestive and Kidney Diseases and related agencies.

Program researchers also are conducting a large-scale study of diabetic retinopathy in Mexican Americans. Diabetic retinopathy is a condition of the retina that can lead to blindness.

The latest study, which appeared in the journal "Diabetes Care," suggested that severe diabetic retinopathy seemed to run in families. Researchers are now working to pinpoint the genes involved in developing the condition, and they continue to identify new cases of it in the county.

In addition, researcher Sharon Brown, a nursing professor at The University of Texas at Austin, is examining whether health-promotional tools and classes help diabetics manage the disease. Through her studies, Brown has offered a year of classes and support groups for Starr County diabetics and their families.

The participants, Brown said, saw "significant reductions in overall blood-sugar levels and significant improvement in their knowledge of diabetes management."

Brown hopes to continue her research to establish what interventions will best help Mexican Americans manage diabetes.

If their grants hold up, the researchers plan to work in Starr County for years to come, they said.

"We committed that when we came, we would stay," Hanis said. "So many researchers do studies and then leave, but we wanted to integrate into the community."

And integrate they have. The Rio Grande City field office offers free blood-sugar and health screenings each week, and the turnout is always high, said office manager Hilda Guerra. Residents also look to the office for doctor referrals and education.

Lopez, who has diabetes, said he and his family see the office as a resource.

"All of my family's been by the program (office) to check themselves," he said.

With the staff's help, he added, "I've learned to eat and how to take care of myself ... I check my insulin every morning."

Hanis said he thought the classes and screenings have helped raise awareness among Starr County residents, even if they haven't reduced the diabetes rate.

"They're more aware that it's controllable, that it's not fate you'll develop eye or kidney complications," he said.

He's also optimistic that their current and future research will bring them closer to a cure, or at least a way to delay the disease's onset.

"The state of Texas, the nation, isn't prepared for what's going to happen with diabetes ... we're in for a rocky road if we don't figure out in the next decade or so how to prevent this," Hanis said. "I'm an optimist -- I think we'll figure it out."

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Copyright (c) 2006, Valley Morning Star, Harlingen, Texas

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Source: Valley Morning Star (Harlingen, Texas)

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