By MARILYN MCMAHON, NEWS-PRESS STAFF WRITER
December 19, 2017 5:38 AM
In a 10-year project launched recently by William Sansum Diabetes Center, 1,000 local families will participate in a study that will have global impact and help researchers understand why Latinos are getting diabetes at an alarming rate. "In Santa Barbara County, diabetes cases have increased by 41 percent over the past decade and now exceed state levels," said Dr. David Kerr, who is charge of the project, which is called Mil Familias or SB1K, standing for "Santa Barbara One Thousand." "Latinos make up 43 percent of the population in Santa Barbara County, and the rates of cardiometabolic disease are persistently higher than the rest of the population due to a combination of factors beyond biological risk, including economics, culture and education," he said. "This research, which is sponsored by Eli Lilly and Co. based in Indianapolis, will not only help us understand the high rate of diabetes among Latinos but also high-risk populations across the globe." Mil Familias has three major local partners: Santa Barbara Neighborhood Clinics, UCSB Department of Actuarial Sciences and LoaCom. Additional local supporters include the UCSB Department of Communication and UCSB Chicano Studies Institute. According to Dr. Kerr, who is the director of research and innovation at WSDC, the first phase of the study will deal with Type 2 diabetics "living with about 100 variables covering five major determinants of human health — genetics, biology, psychology, behavior and societal factors such as pollution, crime, poverty, access to care and food insecurity." The most common form of diabetes is called type 2 or non-insulin-dependent diabetes. This is also called adult onset diabetes, since it typically develops after age 35. People with type 2 are able to produce some of their own insulin. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy.
Helping with the massive undertaking are "promotoras" who have been hired from the Latino community to recruit families for the study and to learn how to use digital health technology needed for some of the screening. Beatrice (Betty) Angeles is one of them. She immigrated from Peru and has been in the United States for more than 35 years. The mother of four children lives in Santa Barbara and says her mother inspired her to be a promotora "because in her community, she always helped people who didn't have anything to eat. She would bring them to our home, but she didn't want them to feel bad about not having food so she would pretend we were having a party. "She would say, 'I'm going to have a party at my home. I'm going to have food there, so come.' When I came here, something inside of me said, 'Betty, you have to help people.' " Ms. Angeles, who finds her work as a promotora "amazing," thinks that diabetes is common in Latino families because "they think when they start with the medicine and symptoms are gone, they are fine, but they don't know that as time goes on, diabetes can affect the organs. That is what they don't understand." In the short time she has been working with the Mil Familias study, she is seeing positive results. "When I interview people from the first to third meeting, they change. They understand they need to change in order to live longer. Now, they understand they need to take care of their diabetes. Mil Familias is going to be proud in the future when they see the results because they already put the seeds of change inside of the participants."
In April, active recruitment of participants for the program will begin. "They must be Latino and at least one family member must have type 2 diabetes for at least a year. To participate, a family simply provides information about their health, lifestyle and environment to create a one-of-a-kind database for Latino diabetes," said Dr. Kerr. "The areas of interest include over 90 different variables related to diabetes, spanning from 'traditional' diabetes markers such as blood test values and family history to 'nontraditional' influences such as food insecurity, crime, pollution and transportation. "During the program, families meet with their promotora at various times throughout the year for a series of data-collection activities including interviews, questionnaires and wearable activity monitors (similar to a FitBit). Each family member also receives lab testing and a physical exam with a local medical provider. Ultimately, the researchers aim to better understand diabetes among the Latino community and identify what we can do to improve lives for families facing diabetes," he added. "Data collection will occur annually for each of the 10 years of Mil Familias with education, prevention and treatment initiatives occurring in parallel. By year three, Mil Familias intends to engage with all 1,000 families, at which point it is likely there will be enough data to develop culturally relevant and meaningful plans to prevent and control diabetes." "After the data is collected, our plan is to work with the people on how to prevent diabetes, how to control diabetes and how to reduce the possibility of serious complications such as stroke, kidney failure, blindness, amputations and heart attack," said Dr. Kerr, a native of Dumfries, Scotland, who has lived in Santa Barbara for four years. "This is my third time in the U.S. In the 1990s, I was a research fellow at Yale University for two years. In 2010, I edited a medical journal in San Francisco, and now I'm in Santa Barbara and excited to be working on this study," he said. "When this project is over in 10 years, we will have found a great deal of new information about diabetes. What we do know now is that there is more to this than diet and exercise."