The diabetes epidemic in the United States (US) has evolved considerably over the last quarter century. Of note, the growth in prevalence and absolute numbers of people with diabetes has far exceeded statistical projections. Growing proportions of those affected by diabetes are people of minority race/ethnicities and from lower socioeconomic backgrounds, and onset and first diagnosis appear to be younger than in decades past.
Though the evidence base for diabetes prevention and management has grown ‒ and with that, some improvement in care and control of diabetes and associated co-morbidities ‒ major gaps persist:
1) The proportion of people with undiagnosed diabetes and prediabetes has not improved; 2) Engagement in prevention is exceedingly low; and 3) Young adults and disenfranchised populations with diabetes fare poorly in terms of control.
And, while incidence rates of “classical” diabetes complications like myocardial infarction, stroke, and amputations have dramatically declined in the last 20 years, again, these declines were less impressive for young adults, minorities, and low socioeconomic populations; and there have been increases in other diabetes complications like cognitive decline, depression, and heart failure. As such, it appears that younger people with diabetes will contend with classical complications earlier in life and older Americans with diabetes will contend with more years of physical and mental disability. This has profound implications for US health care in terms of the volume, complexity (i.e., multi-morbidity) of cases, and health system costs related to diabetes.
To address these trends in the Southeastern US, where disparities in diabetes outcomes are particularly apparent, Emory University, Georgia Institute of Technology, and the Morehouse School of Medicine have established the Georgia Center for Diabetes Translation Research (GCDTR). With its broad base of expertise; wealth of federal- and foundation-funded project platforms; access to communities, health systems, local and federal government; and readily-available tools and technologies; the GCDTR is poised to accelerate the conduct and use of diabetes translation research in the Southeast.
The GCDTR offers Translation Research Cores (Design and Evaluation; Engagement and Behavior Change; and Disparities) designed to be responsive to the need to close remaining gaps in diabetes detection, prevention, and care, and to the changing profile of the US diabetes population. GCDTR brings a spirit of innovation, collegiality, multidisciplinarity, inclusivity (e.g., considering disparities from traditional [race/ethnic] and new perspectives [e.g., disparities across the lifespan; disparate outcomes in people with depression or cognitive decline]), and continued learning towards promoting more and useful diabetes translation research. Further, the GCDTR’s Regional Core, Enrichment Program, and Pilot and Feasibility Program will “grow the pie” and generate awareness and demand, linkage to expert faculty, tools (e.g., open-access resource library) and opportunities (e.g., pilot and micro grants), and host online and in-person platforms to engage with GCDTR and its base of tremendous resources.
K.M. Venkat Narayan, MD, MSc, MBA, is Ruth and O.C. Hubert Chair of Global Health, Director of the Emory Global Diabetes Research Center, Director of the Georgia Center for Diabetes Translation Research and Professor of Medicine & Epidemiology at Emory University in Atlanta, Georgia. He was formerly chief of the diabetes science branch at the US Centers for Disease Control and Prevention (CDC). Dr. Venkat Narayan is noted for substantial, multidisciplinary work in diabetes public health. He has been involved in several major national and international multi-center epidemiological studies, public health surveillance, translation research, and intervention studies. He is currently also exploring intriguing differences in the pathophysiology of type 2 diabetes in South Asian and other developing countries’ populations globally. With more than 400 publications (Relative Citation Ratio in top 1% on NIH Icite; H-index >60 on Thompson; >110 on google. Scholar), including several high-impact studies, his work exemplifies his leadership in diabetes public health. Dr. Venkat Narayan is a member of the US National Academy of Medicine, and is Fellow of the Royal College of Physicians of Ireland, Fellow of the Faculty of Public Health Medicine, UK, Fellow of the American College of Physicians, and Fellow of the American Heart Association. He won the American Diabetes Associations’ Kelly West award for outstanding achievement in epidemiology in 2015, Danish Diabetes Academy Visiting Professor award 2015-17, Government of India, Nehru Chair 2016, and Emory University’s Mentor of the Year award in 2011.
Mohammed K. Ali, MBChB, MSc, MBA, is Associate Professor in the Hubert Department of Global Health and the department of Epidemiology at Emory and an advisor for the Division of Diabetes at the CDC. He is also Associate Director of the Georgia Center for Diabetes Translation Research. He is a lead investigator on a number of studies in the US and overseas. His interests span topics ranging from global estimates of diabetes, understanding diabetes phenotypes, management and prevention of diabetes, and implementation models that achieve positive health outcomes. With CDC colleagues, Ali helps manage a collaborative network of investigators that evaluate the effects of different policy changes on diabetes prevention and control, and is a scientific advisor for the National Diabetes Prevention Program.