The purpose of this project is to move beyond the conventional view of diabetes as a disease that is managed only through blood glucose control. Instead, we aim to reframe diabetes as a condition for which complete remission may become achievable in the future, by connecting advanced medical research with community-based healthcare.

Research led by Professor Hideto Kojima and his colleagues has reported that, in diabetic mouse models, intervention targeting abnormal bone marrow-derived cells, combined with temporary treatment using insulin and an HDAC inhibitor, may help maintain normal blood glucose levels even after treatment has ended. This supports a new perspective in which diabetes is not viewed solely as a pancreatic disease, but as a systemic condition involving bone marrow-derived cells and epigenomic abnormalities.

Based on these research findings, Biozipcode Inc. aims to establish a clinical research model in Palau that evaluates safety, feasibility, the combined effects of lifestyle improvement, and biomarker analysis. In the future, we hope to develop this into a diabetes care model that can be expanded to other countries.

This project aims to collaborate with local medical institutions, including Belau National Hospital, the central medical institution in Palau. Belau National Hospital plays an essential role in the country’s healthcare system, including regional medical care, chronic disease management, and preventive healthcare.

The planned investigator-initiated clinical trial will target patients with diabetes and individuals at risk of diabetes. Under medical supervision, the program will combine candidate treatments, nutritional guidance, exercise support, blood glucose monitoring, and clinical data analysis.

Specifically, physicians, nurses, nutritionists, physical therapists, and clinical research coordinators will work together to continuously evaluate HbA1c, blood glucose fluctuations, body weight, blood pressure, liver and kidney function, and lifestyle-related data. The research plan also includes a treatment model involving 5-ALA and biguanide-class agents, safety monitoring, Biopanning and FACS analysis, wearable medical devices, and AI-based data analysis.

Improving diabetes requires more than medication or candidate treatments. Daily diet, exercise, sleep, weight management, stress management, and continuous monitoring are all essential elements.

The model envisioned by Biozipcode Inc. combines nutritional guidance by qualified professionals, dietary improvement that respects local food culture, exercise programs, and daily health data collection through blood glucose monitoring devices and wearable technologies.

In addition to supporting clinical trial participants, education for families, schools, workplaces, and local communities will also be important. By using radio, television, social media, and community events, we aim to communicate diabetes not as an individual problem, but as a national health challenge that can be improved through collective action.

This project also aims to build academic partnerships with local colleges in Palau. Palau Community College offers programs related to community and public health, as well as nursing education, providing an important foundation for developing local healthcare professionals.

In the future, we aim to support the training of nurses, nutritionists, clinical research support staff, data management personnel, and community health workers, thereby helping Palau build a sustainable system for diabetes prevention and care.

In addition, through collaboration with Japanese universities and research institutions, we plan to promote online lectures, short-term training programs, clinical research training, and joint research presentations. In the long term, we will also explore the possibility of satellite-style medical education to train physicians and healthcare professionals who understand the unique medical challenges faced by island nations.

The model to be built in Palau is not merely a clinical trial project. It is intended to become a “South Pacific medical model” that integrates clinical research aiming for diabetes complete remission, lifestyle improvement, preventive education, medical human resource development, data analysis, and medical tourism.

Palau’s relatively small population makes it easier for healthcare providers, government agencies, educational institutions, and local communities to work together. This creates a strong opportunity to evaluate the social impact of diabetes prevention and treatment at the national level, and to develop a model case that can be shared with the world.

We plan to establish Palau as a demonstration site for diabetes complete remission, with future development into investigator-initiated clinical trials, cell-targeting technology, diagnostic markers, and medical tourism.

Ultimately, based on the knowledge and data gained in Palau, we aim to expand this model to Japan, the UAE, the United States, the Asia-Pacific region, and beyond, delivering new options to people suffering from diabetes around the world.