Traditionally, the ADA research pro-gram provided a majority of its funding to basic science research. However, as the program has matured, it has become clear that translational research, at both the bench-to-clinic and clinic-to-community interfaces, is critical for improving patient outcomes. As a result, the Association has made a concerted effort to increase the proportion of translational and clinical grants that are awarded and, in the last 5 years, has increased this proportion of clinical work in the portfolio to ;35% (Fig. 5). This shift in emphasis facilitates more laboratory-to-human translation, ex-ploratory clinical work, clinic-to-community translation, and patient-centered out- program, the Pathway program. The intent of this program is to further expand the field of diabetes research by supporting exceptional scientists performing innova-tive and transformational research. This program will be available to individuals who have been identified as having ex-traordinary potential to make significant contributions and are early in their inde-pendent research careers, or are under-taking a significant change in their research focus. These awards will encourage the exploration of new ideas and multi-disciplinary approaches to diabetes re-search. The recipients will benefit from a substantial financial commitment over a longer period of time than is traditionally offered. To further increase the likelihood of success and progress, this program will also provide flexibility in the use of the funds, extensive individualized mentor-ship from distinguished researchers, and comes research. STRATEGIC RESEARCH PRIORITY AREAS—While the ma-jority of ADA research dollars are allocated to investigator-initiated research over a wide range of topic areas, a percentage of the portfolio is used to support targeted and collaborative research initiatives in stra-tegically important areas. Most targeted re-search funding is subsidized by collaborative 1382 DIABETES CARE, VOLUME 35, JUNE 2012 care.diabetesjournals.org Fonseca and Associates —Training and career development grant opportunities. The ADA offers grant opportunities for training and career development that cover the spectrum of academic career stages. Approximately 38% of the budget of the program in 2011 was dedicated to training and career development awards. sponsorships with individual donors, other funders of diabetes research, or in-dustry partners. These opportunities are announced in specific requests for appli-cations throughout the year. Recent ex-amples of targeted initiatives include grants that have supported novel research on diabetes care delivery, studies examin-ing the neurohormonal control of metab-olism, and clinical and translational efforts to understand the impact of hypoglycemia. Larger federal research initiatives, often originating with the NIH, have also been sup-ported with ADA research contributions— most notably the Diabetes Prevention Trial–Type 1 (DPT-1), the Diabetes Preven-tion Program (DPP), the Hyperglycemia and Adverse Pregnancy Outcome Study (HAPO), and the Veterans Affairs Diabe-tes Trial (VADT). Although targeted research is not strictly limited to the following areas, these topics serve as strategic priorities to guide targeted and collaborative activities. Type 2 diabetes prevention Early identification of impaired glucose tolerance, coupled with weight loss and physical exercise interventions, can delay the onset of type 2 diabetes significantly. The ADA was a critical collaborative partner in the National Institute of Di-abetes and Digestive and Kidney Diseases (NIDDK)-sponsored DPP, which demon-strated that lifestyle modification or treat-ment with metformin can delay the incidence of developing diabetes by 58% and 31%, respectively. Findings indicated that even modest weight loss can significantly mini-mize risk (12). In addition, a recent anal-ysis of 10-year follow-up data from the DPP showed that both lifestyle interven-tion and metformin treatment were highly cost-effective treatments for patients with prediabetes (13).Despite this strong evidence, diabetes prevention is often not emphasized or practiced. Reasons for this may include lack of awareness in the general popula-tion of the seriousness of the attendant risks of diabetes, insufficient clinical ef-forts to screen patients, limited availabil-ity of prevention programs, and societal barriers to adherence to healthy behavior. In the DPP, ;11% of participants in the control group progressed to type 2 diabe-tes each year (12). However, the DPP par-ticipants were selected as a particularly high-risk cohort, with most having com-bined impaired glucose tolerance and im-paired fasting glucose. For the 79 million individuals in the U.S. with the broader spectrum of prediabetes, reliable and straightforward means for distinguishing those who will progress to diabetes from those who will not are needed to most efficiently target resources. Further studies characterizing the pathways that underlie the development of the disease are nec-essary for identification of novel risk fac-tors and early biomarkers that could predict progression and facilitate identi-fication of the population in need of pre-ventative treatment. Studies aimed at translating research-based prevention programs into clinical and community-based practice, and studies examining cost-effective and novel means of deliv-ering prevention are also necessary. Due to the size and trajectory of the problem, the potential benefits that could result from subsequent prevention strategies are enormous. Type 1 diabetes prevention Analogous prerequisites for widespread prevention of type 2 diabetes also apply to prevention of type 1 diabetes: the identi-fication of those in the general population that are at highest risk and the identifica-tion of the best therapies and the point at which interventions are appropriate and effective. Since the identification of an au-toimmune origin of type 1 diabetes, investigators have been examining ways to modulate the immune system to pre-vent (or reverse) the autoimmune process and preserve or restore b-cell function in patients at risk for or early in the course care.diabetesjournals.org DIABETES CARE, VOLUME 35, JUNE 2012 1383 Commentary—Portfolio distribution of awards supported by the ADA in 2011 (proportions of 2011 allocations in dollars). The majority of the portfolio is dedicated to support of Core Program awards including basic, clinical/translational, and innovation projects. Approximately a quarter of the budget supported career development