NIH Diabetes Study Targets New Haven Clinic

Jan 15, 2014

Georgina Castellan, left, visits with Elizabeth Magenheimer and Mari Montosa at Fair Haven.
Credit Fair Haven

A new nationwide study funded by the National Institutes of Health is examining treatment options for Type 2 diabetes and a New Haven clinic serving low-income patients has been named a "co-investigator."

At last check, the Centers for Disease Control estimated nearly 20 percent of Americans aged 65 and older have Type 2 Diabetes. For certain populations, those rates are even higher. "If you are of Hispanic origin and you're over 65, I think there's a one out of three chance that you have diabetes," said Silvio Inzucchi, professor of medicine and the director of Yale's Diabetes Center.

Inzucchi said several things contribute to those "extraordinary numbers": a lack of good nutrition, and access to health care, to name just two. Now, Inzucchi is working with Fair Haven -- a clinic serving predominantly low-income Hispanics -- as part of a national study called GRADE. It will examine drug treatments for Type 2 diabetes. "It's a disease that is always with you," Inzucchi said. "I tell patients, it's not bronchitis; you can't take ten days of penicillin and get rid of it."

The clinic holds evening hours and often coordinates transportation with patients.

In recent years, doctors have butted heads about what exactly you can take to treat Type 2 diabetes. There's agreement on one drug, metformin, which has been around for about 50 years, and suppresses glucose production in the liver.

But after that, doctors aren't so sure. Anne Camp, a doctor who directs Fair Haven's diabetes prevention program, said, "In the last 15 to 20 years, there have been nine new classes of medications to treat Type 2 diabetes that have been developed." She said doctors know all these drugs work to lower blood glucose, but they don't know how well. GRADE hopes to find out by comparing four different types of drugs over a five- to seven-year period.

Many of the participants in GRADE are low-income, non-native English speakers. As Camp says, they are not your typical test subjects. "It's been important in what we do here," she said, "to ensure that the patients we take care of are adequately represented in lots of ways. For me, part of that means adequately represented in clinical research." Camp said she gets frustrated when low-income patients are left out of drug studies. "Because access to these studies is difficult," she said. "There are transportation issues. There are time issues, work issues."

Fair Haven is working to remove those barriers. The clinic holds evening hours and often coordinates transportation with patients. And then there's the benefits of the GRADE study itself. Silvio Inzucchi said participants will receive free medications and checkups for their diabetes throughout the study. "The other benefit," he said, "is just helping society and scientists learn about diabetes and how to best manage -- so there will be benefit to future generations as we try to figure out the best management of this disease." 

Yale and Fair Haven hope to enroll about 150 participants. Overall, GRADE will study about 5,000 patients spread across nearly 50 clinical centers nationwide.

For more information on how to enroll as a GRADE participant, visit their website.