The American Diabetes Association Diabetes Research PerspectiveVIVIAN A. FONSECA, MD1,2 TAMARA DARSOW, PHD4M. SUE KIRKMAN, MD3 ROBERT E. RATNER, MD5activities and their impact on the field of diabetes research, prevention, care, and public health.The burden of diabetes is enormous and escalating at an alarming rate (1–3). Nearly 26 million Americans have the disease, including over 10% of the total adult population and over 25% of the population aged 65 years and older. While most of those individuals have type 2 diabetes, nearly 1 million Americans have type 1 diabetes. An additional 79 million American adults have prediabetes, which, when added to those with diabetes, sug-gests that nearly half of the adult population currently has impaired glucose metabolism (1). If present trends continue, as many as one in three American adults will be diag-nosed with diabetes by 2050; the major-ity of cases will include older adults and racial and ethnic minorities (4). The high prevalence of diabetes, especially among the aging population, comes at a considerable economic cost. In 2007, diabetes and prediabetes ac-counted for approximately $218 billion in direct medical costs and lost produc-tivity in the U.S. (5). Health care expen-ditures for individuals with diabetes are 2.3 times greater than expenditures for those without diabetes, and diabetes complications account for a significant proportion of those costs (5). Diabetes significantly increases the risk of cardio-vascular events and death, and is the leading cause of end-stage renal disease, blindness, and nontraumatic lower-limb amputations in the U.S. (1). Despite me-dical advances significantly decreasing the risk of complications and associated mortality, the trajectory of these declines has been blunted by the overall increase in the number of people afflicted with diabetes. Decades of intensive research have resulted in vastly improved understand-ing of the pathophysiology and impact of diabetes, as well as a host of new and im-proved therapies. The translation of this research into practice has led to reduc-tions in chronic complications and mor-tality in people with diabetes (6). Yet, as the incidence and prevalence of both type 1 and type 2 diabetes continue to escalate, the need for innovative research and as-sociated evidence-based care and preven-tion is increasingly vital to protect the public health and to help control the surging costs of diabetes-related health care. The American Diabetes Association (ADA) is committed to improving the lives of all those with or at risk for the disease, irrespective of the disease type, age, or ethnic origin of the individual with the disease. Our vision is a life free of diabetes and its burdens. Research holds the key to understanding and combating this illness, and stemming the rising tide of the epidemic. However, the importance of the ADA as an organization is seen not only in its commitment to research funding, but also in showcasing new research find-ings in the most prestigious scientific meeting and the leading scientific journals dedicated to diabetes in the world, synthesis and interpretation of research into position statements and standards of care, efforts to translate research findings to community-based practice, and advocacy to foster more research. All of these activities to-gether lead to translation of the research from the bench to the clinic and to better outcomes for people with diabetes (Fig. 1). In this article, we will describe these RESEARCH AT THE ADA—Research is at the core of the ADA’s efforts to serve its constituency of individuals with diabe-tes and those at risk for the disease. The association has a long history of research support and engagement. The first direct ADA research grants were awarded in 1952. In the late 1970s, the ADA’s research funding was centralized into a grant pro-gram modeled after that of the National Institutes of Health (NIH), with operational and scientific oversight housed in the na-tional office. The program is guided by two national volunteer committees: the Re-search Policy Committee, which advises on research strategy, portfolio manage-ment, and special programs, and the Re-search Grant Review Committee, a panel of independent, volunteer scientific and medical experts in a broad array of disci-plines who review and prioritize all appli-cations for the ADA research support. Since the inception of the research grant program, the ADA has invested more than $600 million in diabetes re-search, funding nearly 4,000 individual projects. In 2011 alone, the ADA committed $34.6 million to research and supported more than 400 ongoing projects at 139 leading research institutions across the U.S. A recent analysis of the ADA-funded investigators illustrates the positive impact associated with these efforts. In a representative cohort of investi-gators supported in fiscal year 2005, fully 98% remained dedicated to diabetes re-search through 2011. These individuals were extremely productive, with the aver-age ADA award directly resulting in ap-proximately six peer-reviewed primary publications. They became leaders in the diabetes scientific community, with more than a third of investigators assuming a From the 1Division of Endocrinology, Department of Medicine, Tulane University Medical Center, New Orleans, Louisiana; 2President, Medicine & Science, American Diabetes Association, Alexandria, Virginia; 3Medical Affairs and Community Information, American Diabetes Association, Alexandria, Virginia; 4Research Programs, American Diabetes Association, Alexandria, Virginia; and the 5Scientific and Medical Division, American Diabetes Association, Alexandria, Virginia. Corresponding author: Tamara Darsow, tdarsow@diabetes.org. DOI: 10.2337/dc12-9001 © 2012 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/ licenses/by-nc-nd/3.0/ for details. leadership position (e.g., directors, chairs, chiefs) during that timeframe, and nearly half receiving scientific achievement awards. Moreover, and perhaps most im-portantly, 85% of the investigators received additional funding for their research