Group calls for sweeping funding for research

Battle plans to reverse toll of diabetes

The congressionally mandated Diabetes Research Working Group (DRWG) unveiled its battle plans in late February and called on Congress to take up the challenge by allocating $827 million toward the race for prevention and a cure.

The high price tag will pay off in the end if headway is made against the disease, which costs $100 billion a year in health care and an untold toll in terms of human misery, says C. Ronald Kahn, MD, DRWG’s chairman and director of the Joslin Diabetes Center in Boston and the Mary K. Iacocca professor of medicine at Harvard Medical School.

"We are taking action now that will save many thousands of men, women, and children from the severe consequences of a dangerous and life-threatening illness, as well as save the nation billions of dollars in medical care and lost productivity," he says.

The report points out that government-funded diabetes research represents less than 3% of the research budget of the National Institutes of Health (NIH), even though diabetes is one of the most costly diseases our society encounters and mortality has increased by 30% since 1980.

Calling diabetes "a public health crisis," Rep. George Nethercutt (R-WA), co-chairman of the bipartisan Congressional Diabetes Caucus pledged to fight for the funding. "Over the last two decades, funding for diabetes has not kept up with scientific opportunities or public needs," Nethercutt says.

DRWG identified what it calls "five extraordinary opportunities for making significant progress toward understanding, more effectively treating, and ultimately preventing and curing diabetes."

"The extraordinary opportunities we identified — genetics of diabetics, autoimmunity and the beta cell, cell signaling and regulation, obesity, and clinical research and trials — highlight areas where recent advances in technology and knowledge would have the most profound impact on people with diabetes," says DRWG member Christopher Newgard, PhD, the holder of the Gifford O. Touchstone Jr. and Randolph G. Touchstone chair in diabetes research at the University of Texas Southwestern Medical Center in Dallas.

Among the DRWG’s recommendations are these goals:

• Establishing a national consortium of researchers with adequate expertise and resources to unlock the genetics of diabetes and its complications, an achievement Kahn thinks is possible in the "next two or three years."

• Creating centers to intensify research on islet cell transplantation.

• Establishing research centers that focus on the failure of cells to communicate on a molecular and genetic level (an underlying cause of Type 2 diabetes).

• Increasing the size, scope, and number of NIH-sponsored obesity research centers.

• Creating Diabetes TrialNet, a network of clinical research facilities that would provide a stable, high-quality base for clinical trials.

• Intensify research on mechanical devices for insulin replacement.

• Enhancing the mechanism for obtaining human material for research, from pancreases to stem cells.

Kahn says DRWG does not advocate creating new physical facilities for research, but to develop a "hub-and-spoke" method of bringing together existing facilities and creating databases so participants in clinical trials can be assembled efficiently and other research efforts can be coordinated.

An emotionally loaded issue

Kahn says the "human material" needed for research is likely to continue to be an emotionally loaded issue as Congress takes up the proposal, "But it doesn’t need to be that way."

While most of the stem cells currently used in research are fetal cells, largely the products of abortions, Kahn says there are other ways to obtain such cells. These methods include harvesting the umbilical cords and placentas of live births and obtaining stem cells that are found "in virtually every organ of an adult."

The DRWG’s $827-million request is $385 million more than the current $442-million NIH funding for diabetes research.

However, Kahn says it’s not a lot of wishful thinking, but he doesn’t expect the funds will be available immediately. "The estimates of needs are realistic and in some cases conservative. I don’t think it’s pie-in-the-sky. It’s the result of some extremely thoughtful consideration."

[C. Ronald Kahn can be reached at (617) 732-2400. A summary of the DRWG’s reports can be obtained at the ADA Web site at www.diabetes.org.]