A clinical study on the prevention of diabetes Bermuda is participating in is emerging to be as much a public health campaign as a research project, Hamilton Rotarians heard yesterday.

Dr. Shane Marshall - the principal sub-investigator for the DREAM study - was the guest speaker at the group's luncheon yesterday.

Dr. Marshall said that almost as many diabetics have been identified through the study's screening process as suitable candidates for the research.

The DREAM study is testing the effect of two medications - ramipril and rosiglitazone - on preventing the onslaught of diabetes in people who are at high risk for developing the disease because they have impaired glucose tolerance (IGT).

To qualify for the study, participants should have IGT but not be diabetic. However, over the course of screening for participants - which began last September - 46 people who have diabetes but did not know have been identified.

Dr. Marshall explained these individuals have benefited from the study as well, however, as screening led to early detection of the diabetes and early treatment.

Forty-seven of those screened were found to have IGT and 34 of those have since been randomised into the ongoing study - the results of which are expected in 2005/06.

All participants are already exhibiting health benefits, Dr. Marshall said, although many are only receiving placebos.

Researchers believe these positive effects result from the consistent monitoring of health indicators in participants and more regular interaction with health care professionals.

The importance of the DREAM study to Bermuda is paramount.

Bermudians have a higher risk of developing diabetes even than Americans.

Recent statistics show that one in nine Bermudians will develop diabetes versus one in 14 in the United States.

Bermudians are also at higher risk to develop heart disease, Dr. Marshall explained due to the many overlapping risk factors between the two health threats.

The prevalence of both diseases in Bermuda is a result of local lifestyles that have become progressively more sedentary over the years.

Dr. Marshall pointed out that years ago, Bermuda's common modes of transportation were bicycles and rowboats rather than cars and fast ferries.

Additionally, Bermudians tend to have diets rich on red meat and fatty foods.

There is also a genetic risk factor associated with diabetes in Bermuda.

"Simply by being Bermudian alone, you are already at higher risk for diabetes," Dr. Marshall said.

Research has found that one in six Bermudians are impaired glucose tolerant. "That represents one of the highest incidence rates in the world," Dr. Marshall said.

To undertake the DREAM study in Bermuda, a team of roughly 20 sub-investigators and 40 volunteers from the hospital, the Diabetes Association, the Heart Foundation and the community screen for participants every Saturday morning at King Edward VII Memorial Hospital.

While some of investigators participating in the mammoth international study keep a portion of the fee allocated per participant in the study, in Bermuda all the funds raised will be divided between the Bermuda Heart Foundation and the Diabetes Association. The DREAM team work completely voluntarily to benefit local patients, Dr. Marshall said, having seen too many local people blinded, lose limbs or die prematurely as a result of the ravages of the disease.

Ultimately, the DREAM team hope to randomise 200 local participants for the study out of a total of 4000 participants worldwide. Those who wish to be considered for the study should contact their physician first for referral to the Diabetes Centre.

For more information on the DREAM study please contact Debbie Jones at the centre (239-2027) or Judith Ruijter (236-2345 x. 2093).