The largest study of its kind, the Diabetes Prevention Program was announced today at the American Diabetes Association's annual meeting in San Francisco. Co-sponsors are the ADA and National Institutes of Health.

The University of Hawaii is con

ducting the program locally, with space and other resources provided by The Queen's Medical Center, 1301 Punchbowl St.

Dr. Richard Arakaki is chief investigator; doctors Ralph Naokalani Beddow and Marjorie Mau are co-investigators. U'ilani Perry is recruitment coordinator.

"It is an ambitious program," said Beddow, explaining that about 150,000 people will be screened across the country to get 4,000 volunteers. The Hawaii center hopes to screen about 1,500 people and select 50 to 60 volunteers, he said.

All sites are trying to recruit ethnic minorities, Perry said. Native Hawaiians are urged to participate because diabetes affects them three times more often than the general population, she said.

Beddow, "holding the fort" while his colleagues are at the ADA meeting, said at least half of the volunteers must be Hawaiians. About 15 percent must be 60 or older.

The team is working with the Native Hawaiian Health Care System and health centers on volunteer recruitment and retention, Beddow said. Some young Hawaiians also will be trained as medical technicians, he said.

The goal is to determine whether people with high blood sugar levels (impaired glucose tolerance) can lower them through diet and exercise or medication and, thus, delay or prevent diabetes.

About 21 million Americans are estimated to have high blood sugar levels - a high risk condition for Type 2 or noninsulin-dependent diabetes.

Impaired glucose tolerance is more common in overweight, elderly and minority groups, and their populations are growing, the NIH said. The World Health Organization has described Type 2 diabetes as an international epidemic, Beddow said.

It's hoped the Type 2 study will be as significant as an earlier study on Type 1 (insulin-dependent) diabetes, which showed how complications of the disease could be prevented or delayed, he said.

Volunteers must be 25 or older with impaired glucose tolerance. Screening will involve a health questionnaire, blood test, physical examination and several other health tests.

Volunteers should be willing to stay in the program three to six years although they may withdraw any time. They will receive free medical tests and checkups and those who develop diabetes during the study will be treated and followed.

Volunteers will be assigned randomly to four groups - one following an intensive diet and exercise program, two examining effectiveness of medications to lower blood sugar levels and the fourth taking placebo pills.

Two drugs will be tested:

- Biguanide metformin, used in Europe for 30 years and approved last year for diabetes treatment in the U.S.

- Troglitazone, part of a new class of drugs that increase sensitivity to insulin. It's still on trial in the U.S. but it has been used in Japan with no significant adverse effects, Beddow said.

He said it will be a "double blind study," which means neither the investigators nor the patients will know what they're getting. "We're trying to eliminate bias," he said.

Beddow said the program has generated interest all over the world, with other countries asking to participate. That's why he left retirement 11/2 years ago when asked to be a co-investigator, he said.

Also, he has Type 2 diabetes.

When he developed the disease four years ago, Beddow said, "I kept denying it. I tried to attribute the symptoms to hard work. As a native Hawaiian, I should have known I would be susceptible."

It was ironic, he said, considering he had been a diabetes specialist for 30 years and founded the Diabetes Center of the Pacific in 1972 at Straub Clinic & Hospital. He's a consultant now to the Joslin Center for Diabetes at Straub.

Perry also has a personal interest in the study. "I'm one of those at risk because of family history," she said, noting her father is a diabetic with many complications.

"When you see what diabetes can do, whether it's heart disease or kidney failure, you want to try to prevent it," she said. "To me, that's what it's about, trying to see if one of these things will work - diet and exercise or medication.

"In the end, the results will benefit everyone."