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Summer 2008 Newsletter

Message from the Director

The MDRTC is pleased to announce two new programs being funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) as a result of discussions with the Executive Committee of the Diabetes Center Programs. I would like to take this opportunity to draw your attention to these programs.

Seeding/Planning Grant for NIDDK R24 Program
The first program is a pilot program that will support the assembly and initial activity of research teams preparing to submit grants for the NIDDK R24 program. The program is being launched under the auspices of the diabetes center program network pilot and feasibility programs. A description of the R24 program can be located at the following URL: http://grants.nih.gov/grants/guide/pa-files/PAR-07-188.html ). Please note that a renewal of this program announcement is currently under development by NIDDK.

Some pertinent information about this opportunity follows:

Release Date: May 5, 2008
Letters of Intent Receipt Date: September 1, 2008
Application Receipt Date: October 1, 2008
Peer Review Date(s): November 2008

Purpose: The complexity and pace of biomedical science often requires input and expertise from many more than one investigator. Currently support for collaborative research takes the form of a large R01 with one PI and one or more key personnel, a multi-PI R01, a Program Project Grant (P01) with 3 or more individual and independent projects and cores centered on a common theme, or a Center that supports a focused set of activities. Other large research mechanisms often utilize cooperative agreements that also entail significant involvement of the NIH in the planning and execution of research objectives. In large collaborative efforts synergies are built out of the interactions between and among the projects and investigators of these focused efforts. This initiative is designed to apply the flexibility of the Research Resource Project Grant mechanism (R24) to provide resources for problems where multiple levels of expertise are needed to focus on a single complex problem in biomedical research relevant to the mission of the Division of Diabetes, Endocrinology and Metabolic Diseases (DEM) at NIDDK.

Budget and Project Period: Budgets for direct costs of up to $75,000 per PI and $300,000 per year per award, with project duration of up to one year may be requested.

Eligible Project Directors (PDs)/Principal Investigators (PIs): Individuals with the skills, knowledge, and resources necessary to carry out the proposed research are invited to work with their institution/organization to develop an application for support. Individuals from under represented racial and ethnic groups as well as individuals with disabilities are encouraged to apply. This opportunity is not limited to investigators associated with NIDDK Diabetes Centers or their affiliated institutions.

Number of PDs/PIs:
More than one PD/PI, or multiple PDs/PIs, may be designated on the application.
Number of Applications:
Applicant organizations may submit more than one application, provided that each application is scientifically distinct.

Expanded Medical Student Summer Research Training in Diabetes, Endocrinology & Metabolic Diseases (summer 2009)

The second new program being sponsored by the NIDDK will support additional summer research internships for MD students as a result of discussions with the Executive Committee of the Diabetes Center Programs. The program will be administered by the diabetes center program network and implemented through supplements to diabetes center associated T32 grants. NIDDK has agreed to provide additional funds in FY08 to T32 grants associated with Diabetes Centers to support additional summer research internships for MD students in summer 2009. The awards are for a standard stipend plus a limited travel award to attend a national gathering of awardees. NIDDK will provide funds to support ~30-35 trainees under this expanded program (approximately 2/center if all centers participate). NIDDK is asking Diabetes Centers for the names of researchers who are interested in participating in this mentorship program at this time. If you are interested in serving as a mentor for a medical student in the summer of 2009, please contact Linda Potter, Director for Administration at ldpotter@umich.edu who will inform NIDDK of your interest. Medical students will be required to apply directly to the NIDDK for acceptance into this program and will be matched to the Diabetes Center by NIDDK.

The key dates for this program follow:
Application deadline - Feb 2009
Award start date - Summer 2009

MDRTC Core Updates

Animal Phenotyping Core

The Bruker minispec, which provides accurate, repeatable, and facile measurements of body adiposity in living animals without anesthesia arrived in the Phenotyping Core in late May. The equipment is capable of rapidly analyzing body composition, including free water, in unanesthetized rats and mice. The model selected is also capable of being calibrated to unique dummy standards for the analysis of specific lipid signatures to increase accuracy and information obtained. We will keep you apprised of when the equipment will be available for use.

Funding/Award Opportunities

MDRTC Accepting Applications for Pilot and Feasibility Studies

The Michigan Diabetes Research and Training Center (MDRTC) NIH grant supports research initiatives by new and established UM faculty. Grant proposals may be in areas of basic biomedical, clinical, behavioral, epidemiological, health services, or translational research. Proposals should address key questions in the pathogenesis, diagnosis, prevention or control of diabetes, its complications, or related endocrine or metabolic disorders. Translational research projects should focus on the translation of research advances into clinical practice and include the identification of barriers to widespread adoption of new science and the testing of interventions to overcome these barriers. Proposals are for one year of support with requested funding up to $50,000.

The deadline to apply is August 4, 2008 at 5 PM with anticipated funding to begin in early December 2008. Please see the MDRTC website at http://www.med.umich.edu/mdrtc/pilot/pf.htm for more information and how to obtain an application.

MDRTC/MCDC Now Accepting Applications for Diabetes Interdisciplinary Study Program

The Michigan Diabetes Research and Training Center (MDRTC) and the Michigan Comprehensive Diabetes Center (MCDC) are accepting applications for a Pilot and Feasibility Study to promote interdisciplinary collaboration among researchers. This opportunity promotes collaboration between two faculty members from distinct disciplines to focus their combined research strengths on cutting-edge areas in diabetes. Grant proposals may be in areas of basic biomedical, clinical, behavioral, epidemiological, health services, or translational research. Proposals should address key questions in the pathogenesis, diagnosis, prevention or control of diabetes, its complications, or related endocrine or metabolic disorders. Proposals are for one year of support with funding up to $100,000.

The deadline to apply is August 4, 2008 at 5 PM with anticipated funding to begin in December 2008. Please see the MDRTC website at http://www.med.umich.edu/mdrtc/pilot/disp.htm for more information and how to apply.

Citing the MDRTC in publications is critical for continued funding

In order to assure recognition of NIH support for your research, all publications that use MDRTC core services or result from research funded by a Pilot and Feasibility Grant under this grant must cite the grant as a contributing source of support. Failure to acknowledge MDRTC support in publications could seriously compromise our position with NIH and NIDDK. We ask that you include in the Acknowledgement section of manuscripts the following:

“The project described used the XXX core(s) of the MDRTC supported by Grant No. P60-DK020572 from the National Institute of Diabetes and Digestive Kidney Disease.”

or

“This research was supported by a Pilot and Feasibility Grant from the Michigan Diabetes Research and Training Center (NIH Grant P60-DK20572)”.

Please also remember to cite the MDRTC whenever you receive advice from any of the Core directors or co-directors, when you receive financial support from the MDRTC for the use of a core that is shared with other centers (i.e. Animal Phenotyping Core, Vector Core, Protein Structure Core, etc.) and as appropriate, in collaborative studies where you might not be the senior author writing the paper.

The MDRTC is a critical resource for UM, especially junior investigators. Competition for Center renewals is getting increasingly fierce, and it is important that we be able to continue making the case that we are productive. Citing the MDRTC in our papers is important in that regard, and we appreciate your help.

News and Events

The Endocrine Society’s Annual Meeting

The Endocrine Society’s Annual meeting will be held on June 15-18, 2008 in San Francisco, California. The Endocrine Society's Annual meeting offers an unprecedented opportunity to learn about the latest advances in endocrine research and clinical care, while networking and collaborating with more than 7,000 colleagues from around the world. The scientific program at a glance is located at http://www.endo-society.org/endo/program

NIDDK/NCMHD/NIH Conference on Diabetes and Obesity Disparities in Healthcare Systems

The Diabetes and Obesity Disparities in Healthcare Systems conference will be held June 30-July 1, 2008 on the NIH Campus in Bethesda, MD. The aims of the conference are to promote healthcare-based research aimed at reducing or eliminating disparities in diabetes and obesity-related outcomes. In addition, this 1 ½ day conference will feature presentations about important factors in healthcare-based disparities research as well as discussion of unique design, measurement, and methodology issues. There will be presentations from leaders in the field and multiple opportunities for discussion. Concurrent with this conference, the NIDDK has issued a Program Announcement (PA) for R01s on identifying and reducing diabetes and obesity-related health disparities within healthcare systems. For more information, visit the MDRTC website http://www.med.umich.edu/mdrtc/news_events/index.html

Developmental Origin of Health and Disease
The Developmental Origin of Health and Disease conference will be held October 17, 2008 in Forum Hall, Palmer Commons, University of Michigan. The conference is sponsored by the Division of Pediatric Endocrinology, Department of Pediatrics and co-sponsored by the Michigan Diabetes Research and Training Center, Department of Psychology, LS&A, and the Office of the Dean and Reproductive Sciences Program. For more information, visit the MDRTC website http://www.med.umich.edu/mdrtc/news_events/index.html or contact Amanda Howard (Email: amanhowa@med.umich.edu).

68th Scientific Sessions American Diabetes Association (ADA)

The 68th Scientific Sessions of the American Diabetes Association were held in San Francisco, California on June 6-10, 2008. More information is available on line on the 68th Scientific Sessions of the ADA at http://professional.diabetes.org/UserFiles/File/Advance%20Program%203.25.08%20(with%20corrected%20CS).PDF.

MDRTC Winter Symposium

This year’s Winter Symposium and the Ray A. and Robert L. Kroc Lectureship in Diabetes took place on Saturday, April 26. The event was attended by more than one hundred faculty, staff, postdoctoral fellows and students. Seminars were presented by Philipp E. Scherer, Ph.D., from the University of Texas Southwestern Medical Center, and by Jiandie Lin, Ph.D., Matthias Kretzler, M.D., and Randal J. Kaufman, Ph.D., from the University of Michigan. 37 posters were presented during a buffet lunch - our highest number ever.

Research Updates

Research suggests biological reason for higher A1C in U.S. minorities

A recent study reports that A1C levels are higher among U.S. racial and ethnic minority groups with impaired glucose tolerance (IGT) are higher in African Americans, Hispanics, American Indians and Asians than in whites, even after controlling for such differences as age, sex, education, marital status, blood pressure, adiposity, hematocrit, fasting and post– glucose load glucose levels, cell function, and insulin resistance.

Scientists in the Diabetes Prevention Program (DPP) Search Group collected data from 3,819 individuals age >25 years who were eligible for the DPP study, and compared A1C levels between five different racial and ethnic groups both before and after adjusting for the above-mentioned factors. After adjusting, researchers found that the average A1C among whites was 5.78 percent, while the average among Hispanics was 5.93 percent, among Asians was 6.0 percent, among American Indians was 6.12 percent, and among African Americans was 6.18 percent.

The authors report that previous studies have attributed higher A1C levels among minorities to poor glycemic control, however “studies of nondiabetic populations and studies that have compared A1C levels among racial and ethnic groups within organized systems of health care and have carefully adjusted for processes of care have still demonstrated persistent differences in mean A1C. Our findings that factors that differed among racial and ethnic groups or were likely to affect glycemia did not explain differences in A1C, suggest that hemoglobin glycation or red-cell survival may differ among racial and ethic groups.” Further studies are needed to confirm this observation. It is not known whether these racial and ethnic differences in A1C lead to differences in the risk of microvascular, neurologic, or macrovascular complications. The results raise the possibility that A1C may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities. They also raise the important question of whether A1C can be used as a diagnostic test for diabetes. The American Diabetes Association supported the DPP study by providing funds for data collection and participant support.

Herman, WH, Ma Y, Uwaifo G, et al: Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care 30(10):2453-7, 2007

Feedback from Flint: What do vulnerable diabetes patients say about their medication use and cost pressures?

John D. Piette, Ph.D. Director, Program on Quality Improvement for Complex Chronic Conditions VA Ann Arbor Health Care System and Chief of Prevention and Control, MDRTC in collaboration with Micki Juip, MA, BSN, RN, CDE, Basim Towfiq, MD, Anita Harrand, RN, Hurley Medical Center and Michael Giacalone, Jr., MD, Ann Marie Lesniak, MSW, Hamilton Community Health Network, have been researching diabetes patients’ out-of-pocket medication costs in Flint, Michigan. Eight hundred diabetic patients were interviewed about their beliefs about medications, their communication with clinicians about their treatments, and how they are coping with the burden of their medication costs. The study was funded by the American Diabetes Association. Soon-to-be released results will contain some pertinent points for heathcare providers to consider when assisting patients with cost-related medication adherence problems.

New Release: 1000 Years of Diabetes Wisdom

David G. Marrero, PhD, Robert M. Anderson, EdD, Martha Funnell, MS, RD, CDE, and Melinda, D. Maryniuk, Med, RD, CDE recently published 1000 Years of Diabetes Wisdom, an anthology of more than 50 stories about the other side of treating diabetes, what health care providers can learn from patients. With more than 1,000 combined years of working with patients, the contributors share their knowledge and the life-altering experiences that both challenge and change the way health care professionals provide care to their patients. This book is available from the American Diabetes Association at http://store.diabetes.org/products/product_details.jsp

In the News

Eve Kerr MD, MPH, Tim Hofer, MD, MS General Medicine/VA Ann Arbor were in the news in May for their study entitled: Doctors not always sure when to treat blood pressure in people with diabetes. While high blood pressure poses a special threat and multiplies the risk of heart attacks, strokes and kidney problems for people with diabetes, the study finds that many patients aren't receiving adjustments to their blood pressure treatments even when they have high readings during clinic visits, and explores the reasons why this might be happening. Funding for the study came from the VA and the MDRTC. Reference: Annals of Internal Medicine, May 20, 2008, Vol. 148, No. 10.

Accolades to MDRTC Members

The 2008 Harland Winfield Mossman Award, which recognizes remarkable discoveries in stem cell biology, was recently won by Sean Morrision, PhD, the Henry Sewall Professor of Medicine, associate professor of internal medicine and of cell and developmental biology, and director of the Center for Stem Cell Biology. Morrison's lab has identified a number of new mechanisms by which stem cells regulate self-renewing divisions, the process stem cells use to perpetuate themselves throughout life.

Gabriel Nunez, MD, Paul de Kruif Endowed Professor of Academic Pathology, Department of Pathology and Comprehensive Cancer Center, is the recipient of the 2008 Distinguished Faculty Lectureship Award in Biomedical Sciences--the highest award given by the Medical School for Research.

The Rho Chapter of the Sigma Theta Tau International Society of Nursing presented the 2008 Friend of Nursing Excellence award to Cecilia Sauter, MS, RD, CDE.