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The demand for diabetes research funding clearly exceeds the funds available. In the United States, 23.6 million children and adults (7.8 percent of the population) have diabetes, and we spent $174 billion on diagnosed diabetes alone in 2007 (the most recent year for which data are available). It is imperative that we take action, but where is the research funding coming from? Can it possibly be sufficient, and how is it being spent?
From the idea stage, to preclinical (basic) investigations, to clinical trials and beyond, the scientific research required to understand a disease and develop a treatment is formidable and expensive. Once a proposed treatment has been found to be effective using test tubes or animal models, it then moves on to human clinical trials. Clinical trials help researchers find ways to prevent, detect, diagnose, control, and treat illnesses. The researchers and physicians involved in clinical trials must adhere to a strict set of rules that are designed and enforced by the National Institutes of Health (NIH) and the Federal Drug Administration (FDA).
Clinical studies examine drugs in four steps, called Phase 1 through Phase 4. Phase 1 studies test a potential new compound or drug with a small number of volunteers to determine the best dose and evaluate side effects. Phase 2 studies test a drug with known doses and side effects, using a larger number of volunteers to learn more about how the body uses the drug and how the drug helps control the condition. Phase 3 (premarketing) and 4 (postmarketing surveillance) studies are typically randomized, controlled, multicenter trials comparing the new drug with a commonly used drug or the "gold standard" of care.
The National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) is one of a number of branches of the National Institutes of Health (NIH) that support diabetes research. The NIDDK budget estimate for 2010 is approximately $1.9 billion. Six hundred and twenty-five million of that total will be used for research related to diabetes, endocrinology, and metabolic disease; $484 million will go to digestive diseases and nutrition; and $150 million is earmarked for research specifically on type 1 diabetes. These numbers were obtained from the NIDDK 2011 Budget Request.
Others federal institutes funding diabetes research include:
Other government agencies include the Agency for Healthcare Research and Quality (AHRQ), which funds research in healthcare cost and quality, including diabetes care, and the Centers for Disease Control (CDC), which fund translational research in diabetes.
The Juvenile Diabetes Research Foundation (JDRF) has funded more than $1.4 billion in diabetes research since its founding in 1970. In fiscal year 2009, it paid out close to $101 million to support research projects in 22 countries and fund 40 clinical trials.
$33 million went to research on immune therapies - attempting to stop the body's autoimmune response from attacking and destroying beta cells.
$39.8 million went to research on beta cell therapies - promoting either the regeneration of beta cells or their replacement.
$22.1 million went to research on complications therapies - blocking complications affecting the eyes, kidneys, and nerves.
ADA Research Foundation
The ADA Research Foundation has funded over 4,000 research projects since its inception in 1953 and has invested over $500 million in diabetes research since 1980. Its mission is "to ensure the availability of funds necessary for the full exploration of all the scientific possibilities that diabetes research is generating."
Significant ADA discoveries include the invention of the first glucose meter and first insulin pump, the development of oral diabetes medicines to help control blood sugar in patients with type 2 diabetes, and mapping the genetics of both type 1 and type 2 diabetes.
During the last 10 years, the ADA has funded over 1300 grants, including such projects as the development of programmable implantable insulin pumps, the replacement of beta cells for the treatment of type 1 diabetes, and the regeneration of islet cells to prevent type 2 diabetes, currently underway.
Other non-federal funding agencies include the following (adapted from UNC http://research.unc.edu/grantsource/diabetes.php):
A program initiated by the International Diabetes Federation (IDF), called BRIDGES (Bringing Research in Diabetes to Global Environments and Systems), is supported by Eli Lilly and Company. The program's goal is "to help communities around the globe to identify special needs related to intervention and prevention." It focuses on "translational" research, in which currently available knowledge is translated into useful practices for public health.
BRIDGES is supporting 20 translational research projects around the globe, including the "Effectiveness of a group diabetic education programme using motivational interviewing in underserved communities in South Africa," "Improving Diabetes Care in Cap Haitien, Haiti," and "Prevention of type 2 diabetes in women with gestational diabetes in urban India - a feasibility study."
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.