Article from the AAMC Reporter: October 2010

The Academic Researcher: Sugar for the Sea Islands

—By Stephen Pelletier, special to the Reporter

The Sea Islands Genetic African American Registry project (Project SuGAR) has been a significant investigation as much for the way the research was conducted as for its noteworthy findings. A now-classic example of community-based research, the project engaged members of the Gullah-speaking African American population from the Sea Islands of South Carolina in research on Type 2 diabetes—what the Sea Islanders call "sugar." Having endured relatively little outsider immigration, the Gullah population is genetically the most homogeneous population of African descent in the U.S. Because of this isolation, Gullahs have successfully preserved much of their rich and unique culture. But there have also been negative effects. One is in the practice of medicine. A lack of education about modern medicine—and perhaps even some suspicion about it—is pervasive. The Gullahs sustain a culture of root medicine that predates slavery, and medicinal roots are widely available for purchase. Before Project SuGAR, health awareness of diabetes was low. Researchers reported hearing those with the disease say things like "I have a touch of the sugar." Research during Project SuGAR suggested genetic reasons why the Sea Island population has a higher incidence of diabetes than the general population. The work also identified a gene variant that seems to be associated with extreme obesity in African Americans. Perhaps as important, though, the study also modeled an effective approach for partnering with a community—in this case, one whose isolation and previous experiences in scientific studies led it to be suspicious of researchers. The Reporter spoke with two Project SuGAR researchers. W. Timothy Garvey, M.D., is professor of medicine and chair of the department of nutrition sciences at the University of Alabama at Birmingham. From 1994 to 2003, he was professor and director of the division of endocrinology, diabetes, and medical genetics at the Medical University of South Carolina (MUSC), where he started and directed Project SuGAR. Ida Johnson-Spruill, Ph.D., R.N., L.I.S.W., is an assistant professor at MUSC's college of nursing, and was the nurse manager for Project SuGAR from 1995 to 2004.

Reporter: What inspired you to start Project SuGAR?

Garvey: Our original objective was to do a communitybased genetics study for diabetes and obesity genes in the Gullah-speaking African American communities. It was set up with both scientific and social goals, where we could benefit the community as well.

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