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NIDDK
Home : Welcome : Mission
and History
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Mission and History
NIDDK's Mission
The National Institute of Diabetes and Digestive and
Kidney Diseases conducts and supports research on many of the most
serious diseases affecting public health. The Institute supports
much of the clinical research on the diseases of internal medicine
and related subspecialty fields as well as many basic science
disciplines.
The Institute's Division of
Intramural Research encompasses the broad spectrum of
metabolic diseases such as diabetes, inborn errors of metabolism,
endocrine disorders, mineral metabolism, digestive diseases,
nutrition, urology and renal disease, and hematology. Basic
research studies include biochemistry, nutrition, pathology,
histochemistry, chemistry, physical, chemical, and molecular
biology, pharmacology, and toxicology.
NIDDK extramural
research is organized into divisions of program areas:
The Division
of Extramural Activities provides administrative support and
overall coordination. A fifth division, the Division of
Nutrition Research Coordination, coordinates government
nutrition research efforts.
The Institute supports basic
and clinical research through investigator-initiated grants,
program project and center grants, and career development and
training awards. The Institute also supports research and
development projects and large-scale clinical trials through
contracts.
History of NIDDK
Important Events in NIDDK HistoryAugust 15, 1950
President Harry S. Truman signed the Omnibus Medical Research Act
into law establishing the National Institute of Arthritis and
Metabolic Diseases (NIAMD) in PHS. The new institute incorporated
the laboratories of the Experimental Biology and Medicine
Institute and expanded to include clinical investigation in
rheumatic diseases, diabetes, and a number of metabolic, endocrine
and gastrointestinal diseases.
November 15, 1950
The National Advisory Arthritis and Metabolic Diseases Council
held its first meeting and recommended approval of NIAMD's first
grants.
November 22, 1950 Surgeon General Scheele
established NIAMD.
1959 Dr. Arthur Kornberg,
former chief of the institute's enzyme and metabolism section, won
the Nobel Prize for synthesizing nucleic acid.
The
institute initiated an intramural research program in
gastroenterology and launched an intramural research program in
cystic fibrosis with the establishment of the Pediatric Metabolism
Branch.
1961 Laboratory-equipped, mobile trailer
units began an epidemiological study of arthritis among the
Blackfeet and Pima Indians in Montana and Arizona, respectively.
October 16, 1969 The Nobel Prize was awarded to
Dr. Marshall W. Nirenberg of the National Heart Institute who
reported his celebrated partial cracking of the genetic code while
an NIAMD scientist (1957-1962).
November 1970 The
institute celebrated its 20th anniversary. Secretary of Defense
Melvin R. Laird addressed leaders in the department,
representatives from voluntary health agencies and professional
biomedical associations, as well as past and present institute
National Advisory Council members.
May 19, 1972
The institute name was changed to the National Institute of
Arthritis, Metabolism, and Digestive Diseases.
October
1972 Christian B. Anfinsen, chief of the institute's
Laboratory of Chemical Biology, shared a Nobel Prize with two
other American scientists for his demonstration of one of the most
important simplifying concepts of molecular biology, that the
three-dimensional conformation of a native protein is determined
by the chemistry of its amino acid sequence. A significant part of
this research cited by the award was performed while with NIH.
September 1973 The institute's diabetes centers
program was initiated with the establishment of the first
Diabetes-Endocrinology Research Centers.
November
1975 After 9 months of investigation into the epidemiology
and nature of diabetes mellitus and public hearings throughout the
United States, the National Commission on Diabetes delivered its
report, the Long-Range Plan to Combat Diabetes, to Congress.
Recommendations encompassed expansion and coordination of diabetes
and related research programs; the creation of a diabetes research
and training centers program; acceleration of efforts in diabetes
health care, education, and control programs; and the
establishment of a National Diabetes Advisory Board.
April 1976 After a year of study and public
hearings, the National Commission on Arthritis and Related
Musculoskeletal Diseases issued the Arthritis Plan its report to
Congress. The report called for increased arthritis research and
training programs; multipurpose arthritis centers; epidemiologic
studies and data systems in arthritis; a National Arthritis
Information Service and a National Arthritis Advisory Board.
October 1976 Dr. Baruch Blumberg was awarded the
Nobel Prize in Physiology or Medicine for research on the
hepatitis B virus protein, the "Australia antigen," which he
discovered in 1963 while at the institute. This advance has proven
to be a scientific and clinical landmark in detection and control
of viral hepatitis and led to the development of preventive
measures against hepatitis and liver cancer.
April 19,
1977 The director, NIH, established a trans-NIH program for
diabetes, with lead responsibility in NIAMDD.
September
1977 Over $5 million in grants was awarded to five
institutions to establish Diabetes Research and Training Centers.
October 1977 In response to the recommendation of
the National Commission on Diabetes, the National Diabetes Data
Group was established within the institute to collect, analyze,
and disseminate data on this disorder to scientific and public
health policy and planning associations.
December
1977 Institute grantees Dr. Roger C.L. Guillemin and Dr.
Andrew V. Shally shared the Nobel Prize in Physiology or Medicine
with a third scientist, Dr. Rosalyn S. Yalow. Guillemin and
Shally's prizes were for discoveries related to the brain's
production of peptide hormones.
December 1978 A
study of cystic fibrosis focused on the need for future research
activities, including increased support for clinical and basic
research, expansion of specialized CF research resources, emphasis
on training of scientific personnel, and coordination of public
and private cystic fibrosis research activities.
January 1979 Following 2 years of study and
public hearings, the National Commission on Digestive Diseases
issued its report, The National Long-Range Plan to Combat
Digestive Diseases. Recommendations to Congress included the
establishment of a National Digestive Diseases Advisory Board, an
information clearinghouse, and increased emphasis on educational
programs in digestive diseases in medical schools.
December 1979 A task force completed its study
and submitted the report, An Evaluation of Research Needs in
Endocrinology and Metabolic Diseases.
September
1980 Dr. Joseph E. Rall, director of NIAMDD intramural
research, became the first person at NIH to be named to the
distinguished executive rank in the Senior Executive Service.
President Carter presented the award in ceremonies at the White
House on September 9.
October 15, 1980 NIAMDD
celebrated its 30th anniversary with a symposium, "DNA, the Cell
Nucleus, and Genetic Disease," and dinner at the National Naval
Medical Center. Dr. Donald W. Seldin, chairman of the department
of internal medicine, University of Texas Southwestern Medical
School, Dallas, was guest speaker.
June 23, 1981
The institute was renamed National Institute of Arthritis,
Diabetes, and Digestive and Kidney Diseases.
April
1982 HHS Secretary Richard S. Schweiker elevated NIADDK's
programs to division status, creating five extramural divisions
and the Division of Intramural Research.
November
1982 Dr. Elizabeth Neufeld received a Lasker Foundation
Award. She is cited, along with Dr. Roscoe E. Brady of NINCDS, for
"significant and unique contributions to the fundamental
understanding and diagnosis of a group of inherited diseases
called mucopolysaccharide storage disorders (MPS)."
November 1984 Grants totaling more than $4
million were awarded to six institutions to establish Silvio O.
Conte Digestive Disease Research Centers. The research centers
investigate the underlying causes, diagnoses, treatments, and
prevention of digestive diseases.
April 8, 1986
The institute's Division of Arthritis, Musculoskeletal and Skin
Diseases became the core of the new National Institute of
Arthritis and Musculoskeletal and Skin Diseases. The NIADDK was
renamed the National Institute of Diabetes and Digestive and
Kidney Diseases.
June 3, 1986 The National Kidney
and Urologic Diseases Advisory Board was established to formulate
the long-range plan to combat kidney and urologic diseases.
August 1, 1987 Six institutions were funded to
establish the George M. O'Brien Kidney and Urological Research
Centers.
December 25, 1987 In response to
congressional language on the FY 1988 appropriation for the NIDDK,
the institute established a program of cystic fibrosis research
centers.
September 16, 1990 NIDDK celebrated its
40th anniversary. Dr. Daniel E. Koshland, Jr., editor of
Science, was guest speaker.
June 1991 The
NIDDK Advisory Council established the National Task Force on the
Prevention and Treatment of Obesity to synthesize current science
on the prevention and treatment of obesity and to develop
statements about topics of clinical importance that are based on
critical analyses of the literature.
September 30,
1992 Three Obesity/Nutrition Research Centers and an animal
models core to breed genetically obese rats for obesity and
diabetes research were established.
October 12,
1992 Drs. Edwin G. Krebs and Edmond H. Fischer were awarded
the Nobel Prize in Physiology or Medicine for their work on
"reversible protein phosphorylation." They have received grant
support from NIDDK since 1955 and 1956, respectively.
October 30, 1992 In response to congressional
language on the institute's FY 1993 appropriation, the NIDDK
initiated a program to establish gene therapy research centers
with emphasis on cystic fibrosis.
November 1, 1993
The functions of the NIH Division of Nutrition Research
Coordination, including those of the NIH Nutrition Coordinating
Committee, were transferred to NIDDK.
October 10,
1994 Dr. Martin Rodbell and Dr. Alfred G. Gilman received
the Nobel Prize in Physiology or Medicine for discovering
G-proteins, a key component in the signaling system that regulates
cellular activity. Dr. Rodbell discovered the signal transmission
function of GTP while a researcher in the National Institute of
Arthritis and Metabolic Diseases, now NIDDK.
June 22,
1997 Led by NIDDK, the NIH and the CDC announce the National
Diabetes Education Program (NDEP) at the American Diabetes
Association annual meeting in Boston. The NDEP's goals are to
reduce the rising prevalence of diabetes, the morbidity and
mortality of the disease and its complications.
June
2000 In an effort to reduce the disproportionate burden of
many diseases in minority populations, NIDDK initiates an Office
of Minority Health Research Coordination.
November 16,
2000 NIDDK celebrates its 50th Anniversary. Professional
societies in eight U.S. locations and Canada sponsored scientific
symposia and hosted an NIDDK exhibit "A New Century of Science
A
New Era of Hope" is published to highlight research supported and
conducted by NIDDK and concludes the year with a joint scientific
symposium at the Society for Cell Biology's 40th Anniversary
meeting in December.
NIDDK Legislative ChronologyDecember 11, 1947
Under section 202 of P.L. 78-410 the Experimental Biology and
Medicine Institute was established.
August 15, 1950
Public Law 81-692, the Omnibus Medical Research Act, authorized
establishment of NIAMDD to "... conduct researches relating to the
cause, prevention, and methods of diagnosis and treatment of
arthritis and rheumatism and other metabolic diseases, to assist
and foster such researches and other activities by public and
private agencies, and promote the coordination of all such
researches, and to provide training in matters relating to such
diseases...." Section 431 also authorized the Surgeon General to
establish a national advisory council.
May 19, 1972
President Nixon signed P.L. 92-305 to bring renewed emphasis to
research in digestive diseases by changing the name of the
institute to NIAMDD and by designating a digestive diseases
committee within the institute's National Advisory Council.
August 29, 1972 The National Cooley's Anemia
Control Act (PL 92-414) authorized research in the diagnosis,
treatment and prevention of this debilitating inherited disease,
also known as thalassemia, occurring largely in populations of
Mediterranean and Southeastern Asian origin.
July 23,
1974 Public Law 93-354, the National Diabetes Mellitus
Research and Education Act, was signed. The National Commission on
Diabetes, called for by this act, was chartered on September 17,
1974, members were appointed by the HEW secretary. The act called
for centers for research and training in diabetes and
establishment of an intergovernmental diabetes coordinating
committee, including NIAMDD and six other NIH institutes.
January 1975 The National Arthritis Act of 1974
(P.L. 93-640) was signed into law to further research, education
and training in the field of the connective tissue diseases. The
HEW secretary appointed the mandated National Commission on
Arthritis and Related Musculoskeletal Diseases, June 2. The act
required centers for research and training in arthritis and
rheumatic diseases and the establishment of a data bank, as well
as an overall plan to investigate the epidemiology, etiology,
control and prevention of these disorders.
October
1976 P.L. 94-562, the Arthritis, Diabetes, and Digestive
Diseases Amendments of 1976, established the National Diabetes
Advisory Board charged with advising Congress and the HEW
secretary on implementation of the "Long-Range Plan to Combat
Diabetes" developed by the National Commission on Diabetes. The
law also established the National Commission on Digestive Diseases
to deal with many problems, including investigation into the
incidence, duration, mortality rates, and social and economic
impact of digestive diseases.
The National Arthritis
Advisory Board, established by the same law, reviews and evaluates
the implementation of the Arthritis Plan, formulated by the
Arthritis Act of 1974. The board advises Congress, the HHS
secretary, and heads of Federal agencies with respect to the plan
and other Federal programs relating to arthritis.
December 1980 Title II of the Health Programs
Extension Act of 1980, P.L. 96-538, changed the institute's name
to the National Institute of Arthritis, Diabetes, and Digestive
and Kidney Diseases. The act also established the National
Digestive Diseases Advisory Board. The law authorized the National
Diabetes Information Clearinghouse, the Diabetes Data Group, and
the National Digestive Diseases Information and Education
Clearinghouse. In addition, it reauthorized advisory boards for
arthritis and diabetes research.
November 20, 1985
The Health Research Extension Act of 1985, P.L. 99-158, changed
the institute name to the National Institute of Diabetes and
Digestive and Kidney Diseases. The act also established the
National Kidney and Urologic Diseases Advisory Board. The law gave
parallel special authorities to all institute operating divisions,
including authorization of the National Kidney and Urologic
Diseases Information Clearinghouse; National Kidney, Urologic, and
Hematologic Diseases Coordinating Committee; National Kidney and
Urologic Diseases Data System; National Digestive Diseases Data
System; kidney and urologic diseases research centers; and
digestive diseases research centers.
June 10, 1993
The NIH Revitalization Act of 1993, P.L. 103-43, established
NIDDK as the lead institute in nutritional disorders and obesity,
including the formation of a research and training centers program
on nutritional disorders and obesity.
It also provided for
the directors of NIAMS, NIA, NIDR, and the NIDDK to expand and
intensify programs with respect to research and related activities
concerning osteoporosis, Paget's disease, and related bone
disorders.
July 25, 1997 A House report
accompanying H.R. 2264 and Senate report with S. 1061, FY 1998
appropriations bills for Labor/HHS/Education, urged the NIH and
NIDDK to establish a diabetes research working group to develop a
comprehensive plan for NIH-funded diabetes research that would
recommend future initiatives and directions. Dr. C. Ronald Kahn,
diabetes research working group chairman, presented "Conquering
Diabetes, A Strategic Plan for the 21st Century" to the Congress
on March 23, 1999.
Biographical Sketch of NIDDK Director Allen M. Spiegel,
M.D.Allen M. Spiegel, M.D., was appointed Director of the
NIDDK on November 15, 1999. As Director, he leads the national
research effort to combat many of the nations most chronic and
costly diseases. He promotes and supports the development of
trans-NIH research initiatives to harness new developments in
science and technology, and to acquire new knowledge essential to
understanding, treating and preventing diseases within the NIDDK
research mission. He also leads the Department's implementation of
a special program of research initiatives on type 1 diabetes,
which has been established by the Congress.
Spiegel has a
long-standing and productive scientific association with the
NIDDK. He joined the NIDDK's Endocrinology Research Training
Program in 1973, after graduating cum laude from Harvard
Medical School and completing an internship and residency in
internal medicine at the Massachusetts General Hospital. He
subsequently became a senior investigator and later Chief of the
Molecular Pathophysiology Section, Metabolic Diseases Branch. In
1988, he was appointed Chief of that Branch. From 1990-1999, he
served as Scientific Director of the NIDDK, with overall
responsibility for guiding the research efforts of the Institute's
many intramural labs and branches.
Spiegel is an
internationally recognized endocrinologist whose research on
signal transduction has helped to define the genetic basis of
several endocrine diseases. His research established that
inherited disease could be caused by defects in G proteins, which
are intermediaries between hormone receptors and effectors.
Spiegel and colleagues have identified mutations in G proteins
that result in defective cell signaling and cause inherited
disorders such as pseudohypoparathyroidism type Ia and
McCune-Albright syndrome. He also participated in the successful,
collaborative NIH effort to clone the tumor suppressor gene,
which, when mutated, causes the inherited disease multiple
endocrine neoplasia type 1 (MEN 1). Spiegel has received numerous
awards in recognition of his accomplishments, including the Edwin
B. Astwood Lecture Award from the Endocrine Society and the
Komrower Memorial Lecture Award from the Society for the Study of
Inborn Errors of Metabolism.
NIDDK Directors
Name |
Date of Birth |
In Office From |
To |
William
Henry Sebrell, Jr. |
1901 |
Aug. 15,
1950 |
Oct. 1,
1950 |
Russell M. Wilder |
1885 |
Mar. 6, 1951 |
June 30, 1953 |
Floyd S.
Daft |
May 19,
1900 |
Oct. 1,
1953 |
May 3,
1962 |
G. Donald Whedon |
July 4, 1915 |
Nov. 23, 1962 |
Sept. 30, 1981 |
Lester B.
Salans |
Jan. 25,
1936 |
June 17,
1982 |
June 30,
1984 |
Mortimer B. Lipsett |
Feb. 20, 1921 |
Jan. 7, 1985 |
Sept. 4, 1986 |
Phillip
Gorden |
Dec. 22,
1934 |
Sept. 5,
1986 |
Nov. 14,
1999 |
Allen M. Spiegel |
May 18, 1946 |
Nov. 15, 1999 |
|
Research ProgramsDivision of Intramural Research
The Division of Intramural Research conducts research
and training within the Institute's laboratories and clinical
facilities in Bethesda, Md., and at the Phoenix Epidemiology and
Clinical Research Branch in Arizona.
The Division has ten
Branches and ten Laboratories that cover a wide range of research
areas. In addition, there is a section on veterinary sciences and
an Administrative Management Branch.
Eight Branches engage
in basic and clinical research on diabetes, bone metabolism,
endocrinology, obesity, hematology, digestive diseases, kidney
diseases and genetics. The Phoenix Branch develops and applies
epidemiologic and genetic methods to the study of diabetes and
obesity. The tenth branch addresses mathematical modeling of
biological problems.
The Laboratories are engaged in
fundamental research related to the institute's mission (e.g.,
molecular biology, structural biology, chemistry, cell biology,
pharmacology, chemical physics, biochemistry, neuroscience, and
developmental biology). The Laboratory Animal Science section
provides research animal support and collaboration for institute
research programs.
Division of Diabetes, Endocrinology
and Metabolic Diseases
The DEMD supports research and
research training related to diabetes mellitus, endocrinology, and
metabolic diseases including cystic fibrosis. In addition, DEMD
leads the administration of the Trans-NIH Diabetes Program and
coordinates federally supported diabetes-related activities. The
division also administers the Trans-NIH Cystic Fibrosis Program.
Diabetes Research Programs
The
Therapeutic Approaches to Type 1 Diabetes Mellitus Program
encompasses studies of therapeutic approaches to achieving
euglycemia.
Specific areas of support include:
- Transplantation of pancreas, pancreatic endocrine cells
(islets or beta cells) or beta cells in culture (including
procedures to enhance tolerance or to improve transplant
survival upon transplantation).
The Genetics of Type 1
Diabetes Program seeks to identify the genes that predispose to
the development of type 1 diabetes and studies to determine their
mechanism.
Specific areas of support include:
- Studies of animal models of type 1 diabetes such as the NOD
mouse and the BB rat to identify genes responsible for the
development of type 1 diabetes.
- Studies of the HLA region that contains the major genetic
determinant for type 1 diabetes to understand its contribution
to the development of diabetes.
- Studies of immune regulatory regions that may contribute to
both type 1 diabetes as well as other autoimmune disorders.
- Development of genetic resources and patient samples for the
studies on type 1 diabetes.
- Creation of animal models for therapeutic trials.
The Genetics of Type 2 Diabetes Program seeks to
identify genes that contribute to the development of type 2
diabetes mellitus.
Specific areas of support include:
- Studies using animal models to identify diabetes genes.
- Studies using quantitative statistical methods to identify
diabetes genes in human populations.
- Development of genetic resources, patient samples and
methods for studying genetic linkage for diabetes.
The
Clinical Research in Type 2 Diabetes Program will focus on
patient-oriented research (i.e., clinical studies and small
clinical trials) related to: pharmacologic interventions and/or
lifestyle interventions to prevent or treat type 2 diabetes,
including studies relevant to new drug development; development of
surrogate markers for use in clinical trials for the prevention or
treatment of type 2 diabetes; cellular therapies for the treatment
of type 2 diabetes; improving the care of patients with type 2
diabetes.
The Autoimmunity/Viral Etiology of Type 1
Diabetes Program emphasizes support of investigator-initiated
basic and clinical research relating to autoimmune endocrine
diseases, including type 1 diabetes and autoimmune thyroid disease
(AITD). Applications that address the etiology and pathogenesis of
type 1 diabetes, immunology, and viral etiology of diabetes are
included. Studies utilizing animal models to further our
understanding of type 1 diabetes are of continuing interest to
this program. Studies, which emphasize autoimmune thyroid disease,
including Graves' disease, Hashimoto's thyroiditis, and their
complications, are included. Humanized animal models of AITD are
also included.
The Beta Cell Therapy Program
focuses on research to develop alternative cell or tissue sources,
as well as an understanding of the basic mechanisms that support
regeneration or neogenesis of pancreatic islets. This program
supports research in the following areas:
- Developing methods to expand pancreatic islets or beta cells
for transplantation.
- Optimizing growth conditions for islet cell proliferation
and differentiation.
- Deriving pancreatic islets from stem/precursor cells.
- Assessing alternative cell or tissue sources by
transplantation.
- Animal models of islet regeneration and neogenesis.
The Epidemiology Type 1 Diabetes Research Program
focuses on study of the distribution and determinants of type 1
diabetes in populations, including community-based groups and
large patient populations. Specific areas of research include (1)
epidemiologic studies on the genetic and environmental factors
that determine type 1 diabetes; (2) geographic and temporal
variations in the disease; (3) variations in disease frequency by
race, socioeconomic status, metabolic factors, and other
determinants; (4) studies on the etiology of diabetes including
identification of risk factors determining susceptibility to
diabetes and variations in the distribution of risk factors within
populations and within individuals; (5) research on the etiology
and pathogenesis of diabetes in well-defined populations; and (6)
genetic, lifestyle, and environmental factors that predispose
people to type 1 diabetes. Special emphasis is placed on
epidemiologic studies of U.S. minority populations in which the
prevalence and severity of diabetes and its complications are
substantially elevated.
The Epidemiology Type 2
Diabetes Research Program focuses on study of the distribution
and determinants of type 2 diabetes and gestational diabetes in
populations, including community-based groups and large patient
populations. Specific areas of research include (1) epidemiologic
studies on the genetic and environmental factors that determine
type 2 diabetes; (2) geographic and temporal variations in the
disease and variations in disease frequency by race, socioeconomic
status, metabolic factors, and other determinants; (3) studies on
the etiology of diabetes including identification of risk factors
determining susceptibility to diabetes and variations in the
distribution of risk factors within populations and within
individuals; (4) research on the etiology and pathogenesis of
diabetes in well-defined populations; and (5) the genetic,
lifestyle, and environmental factors that predispose people to
type 2 diabetes. Special emphasis is placed on studies of U.S.
minority populations in which the prevalence and severity of type
2 diabetes and its complications are substantially elevated.
The Type 2 Diabetes in the Pediatric Population
Program encompasses research on the pathophysiology,
prevention, and treatment of type 2 diabetes in children.
Specific areas of support include studies:
- To describe the epidemiology (incidence, prevalence, risk
factors) of type 2 diabetes and its complications in children;
- To develop diagnostic criteria to distinguish type 1 and
type 2 diabetes in children;
- To define the metabolic abnormalities (and the natural
history of such abnormalities) in children with type 2 diabetes;
- To develop practical, effective strategies for the
prevention and/or treatment of type 2 diabetes in children; and
- To understand the basis for race/ethnic disparities in the
incidence of type 2 diabetes in the pediatric population.
The Glucose Sensors Program will contain projects
aimed at developing or implementing glucose sensors that can
determine glucose concentration in the plasma, interstitial fluid
or other appropriate space in diabetic patients continuously or in
repeated samples. This program also includes development of the
necessary components of glucose sensors (such as biocompatible
materials or fluorescent glucose ligands, new sampling systems,
etc.), software, mathematical algorithms and circuitry designed
for calibration or insulin pump control, and devices that combine
these sensors with insulin delivery systems in a 'closed-loop'
artificial pancreas.
The Prevention of Type 1 Diabetes
Program includes studies on drug development, and cellular
therapy that are being proposed to prevent type 1 diabetes.
Areas of particular interest are:
- Studies on drug development for type 1 diabetes treatment or
prevention.
- Studies including the creation of animal models for therapy
trials or humans to maintain normal blood glucose levels.
- Tolerance induction for prevention of type 1 diabetes.
- Immune intervention.
- "Humanized" mouse model (development of transgenic NOD with
human HLA molecules on the T cells) for type 1 diabetes.
- Development of therapies for prevention of Impaired Glucose
Tolerance (IGT) or interventions to prevent conversion of IGT to
type 1 diabetes.
- Drugs designed to enhance peripheral glucose metabolism or
reduce hepatic glucose production of type 1 diabetics.
- Therapies designed to increase insulin sensitivity of type 1
diabetics.
The Endocrine Pancreas Program
includes projects to elucidate the basic biology of the endocrine
cells of the pancreas, which include alpha, beta, delta, etc.,
cells within the islet. These include insulin or other hormone
synthesis and secretion, coupling of nutrient sensing to insulin
secretion, cell interactions, role of incretins, cytokines, other
hormones, and enervation, studies of apoptosis and cell turnover
in the adult organ, metabolism, basic signal transduction and
regulation of gene transcription, especially as these areas relate
to beta cell and islet function. This program also contains
studies in cell culture to bioengineer glucose-responsive hormone
secreting cells or islets for eventual treatment of diabetes.
This Hypoglycemia in Diabetes Program encompasses
clinical and basic studies on the pathogenesis, prevention,
treatment and sequelae (including hypoglycemia unawareness) of
hypoglycemia in both type 1 and type 2 diabetes. Specific areas of
research include studies to: identify the neuronal and hormonal
systems involved in recognition and response to hypoglycemia;
examine the interplay of counterregulatory endocrine responses;
and ascertain the regulatory mechanisms for glucose homeostasis
and the cells involved in this regulation.
The Diabetes
Centers Program administers two types of center awards, the
Diabetes Endocrinology Research Centers (DERC) and the Diabetes
Research and Training Centers (DRTC). An existing base of high
quality diabetes-related research is a primary requirement for
establishment of either type of center. While not directly funding
major research projects, both types of center grants provide core
resources to integrate, coordinate and foster the
interdisciplinary cooperation of a group of established
investigators conducting research in diabetes and related areas of
endocrinology and metabolism. The two types of centers differ in
that the DERC focuses entirely on biomedical research while the
DRTC has an added component in training and translation.
The Behavioral/Prevention Research Program
encompasses individual, family, and community-based strategies
aimed at prevention of diabetes and its complications through
lifestyle modifications, education and other behavioral
interventions. Particular emphasis is placed on development of
culturally sensitive, lifestyle interventions to prevent or treat
diabetes in diverse high-risk populations including African
Americans, Hispanic Americans, and Native Americans. Specific
areas of research include: 1) the link between behavior and
physical health as it relates to diabetes and complications; 2)
approaches to improving health-related behaviors and to enhancing
diabetes self-management; and 3) other aspects of diabetes care.
The Type 1 Diabetes Clinical Trials Program
supports large, multi-center clinical trials conducted under
cooperative agreements or contracts. One primary prevention trial
is underway. The Diabetes Prevention Trial Type-1 (DPT-1) is aimed
at determining whether it is possible to prevent or delay the
onset of type 1 diabetes in individuals determined to be at
immunologic, genetic, and/or metabolic risk. It will also support
future clinical trials of the Type 1 Diabetes TrialNet
which will conduct intervention studies to prevent or slow the
progress of type 1 diabetes, and natural history and genetics
studies in populations screened for or enrolled in these studies.
The program also supports the Epidemiology of Diabetes
Interventions and Complications (EDIC) study, an epidemiologic
follow-up study of the subjects previously enrolled in the
Diabetes Control and Complications Trial (DCCT).
The
Type 2 Diabetes Clinical Trials Program supports large,
multi-center clinical trials conducted under cooperative
agreements or contracts. One primary prevention trial is underway.
The Diabetes Prevention Program (DPP) is focused on testing
lifestyle and pharmacological intervention strategies in
individuals at genetic and metabolic risk for developing type 2
diabetes to prevent or delay the onset of this disease.
The Glucose Transport Program encompasses all
aspects of glucose transport in health and disease, especially as
relating to glucose homeostasis in diabetes and obesity. Specific
areas of support include: 1) kinetics and regulation of glucose
uptake in muscle, liver, heart, gut, pancreas, kidney, etc.; 2)
regulation and mechanism of glucose transporter (GLUT) storage,
translocation to the membrane, and gene expression by insulin and
other hormones, glucose, diet, exercise, and metabolic state
(fasting, obesity); 3) structure of glucose transporter; and 4)
kinetic and structural studies of the transport proteins and/or
membrane channels of other nutrients, such as amino acids, ions
and metals.
The Complications of Diabetes Program
encompasses basic and clinical research related to acute (e.g.,
ketoacidosis and hyperosmolar coma) and chronic complications of
type 1 and type 2 diabetes. Chronic complications include the
vascular complications of diabetes and the effects of diabetes on
any organ system. Clinical studies supported under this program
include strategies to prevent or treat the complications of
diabetes. Supported basic research examines the molecular and
cellular mechanisms by which hyperglycemia mediates its adverse
effects and the interrelationships among the mechanisms
potentially involved in the pathogenesis of complications,
including: increased polyol pathway flux; alterations of
intracellular redox state; oxidative stress; glycation of
structural and functional proteins; altered expression of growth
factors; enhanced activity of PKC; impaired synthesis of nitric
oxide and other vasoactive substances; and altered metabolism of
fatty acids.
The Insulin
Receptor/Structure/Function/Action Program encompasses studies
of the structure, function and action of the insulin receptor.
Specific areas of support include: 1) molecular analysis of ligand
binding to receptor; 2) activation of the tyrosine kinase; 3)
subsequent insulin receptor function in signal transduction by
serving as a platform for the attachment of downstream signaling
molecules involved in insulin action; and 4) the Insulin Receptor
Signaling proteins (IRS)-1,2,3,4, and other proteins containing
Src Homology Domains (e.g., SH2).
The Clinical Research
in Type 2 Diabetes Program will focus on patient-oriented
research (i.e., clinical studies and small clinical trials)
related to: pharmacologic interventions and/or lifestyle
interventions to prevent or treat type 2 diabetes, including
studies relevant to new drug development; development of surrogate
markers for use in clinical trials for the prevention or treatment
of type 2 diabetes; cellular therapies for the treatment of type 2
diabetes; and improving the care of patients with type 2 diabetes.
The Adipocyte Biology Research Program encompasses
research that addresses the development and physiology of the
adipocyte cell. Specific areas of support include: 1) studies on
the properties of transcription factors that regulate adipocyte
differentiation; 2) research on the consequences of insulin action
on adipocyte physiology; and 3) use of animal and tissue culture
models to understand adipocyte biology.
The Diabetes
Mellitus Interagency Coordinating Committee (DMICC),
established in 1974 and chaired by the Director, DDEMD, includes
representatives from all Federal departments and agencies whose
programs involve health functions and responsibilities relevant to
diabetes mellitus and its complications. Functions of the DMICC
are 1) coordination of the research activities of the NIH and
those activities of other Federal programs that are related to
diabetes mellitus and its complications; 2) ensuring the adequacy
and soundness of these activities; and 3) providing a forum for
communication and exchange of information necessary to maintain
coordination of these activities.
The National Diabetes
Data Group (NDDG) serves as the major Federal focus for the
collection, analysis, and dissemination of data on diabetes and
its complications. Drawing on the expertise of the research,
medical, and lay communities, the NDDG initiates efforts to: 1)
define the data needed to address the scientific and public health
issues in diabetes; 2) foster and coordinate the collection of
these data from multiple sources; 3) identify important data
sources on diabetes, and analyze and promulgate the results of
these analyses to the scientific and lay public; 4) promote the
timely availability of reliable data to scientific, medical, and
public organizations and individuals; 5) modify data reporting
systems to identify and categorize more appropriately the medical
and socioeconomic impact of diabetes; 6) promote the
standardization of data collection and terminology in clinical and
epidemiologic research; and 7) stimulate development of new
investigator-initiated research programs in diabetes epidemiology.
The National Diabetes Education Program (NDEP),
co-sponsored by the NIDDK and the Centers for Disease Control and
Prevention (CDC), is focused on improving the treatment and
outcomes for people with diabetes, promoting early diagnosis, and
ultimately preventing the onset of diabetes. The goal of the
program is to reduce the morbidity and mortality associated with
diabetes through public awareness and education activities
targeted to the general public, people with diabetes and their
families, health care providers, and policy makers and payers.
These activities are designed to 1) increase public awareness that
diabetes is a serious, common, costly, and controllable disease
that has recognizable symptoms and risk factors; 2) encourage
people with diabetes, their families, and their social support
systems to take diabetes seriously and to improve practice of
self-management behaviors; and 3) alert health care providers to
the seriousness of diabetes, effective strategies for its control,
and the importance of a team care approach to helping patients
manage the disease. Toward these ends, the NDEP is developing
partnerships with organizations concerned about diabetes and the
health care of its constituents.
Endocrinology Research
Programs
The Bone and Mineral Metabolism Research
Program encompasses basic and clinical research on the
hormonal regulation of bone and mineral metabolism in health and
disease. Specific areas of support include: 1) endocrine aspects
of disorders affecting bone, including osteoporosis, Paget's
disease, renal osteodystrophy, and hypercalcemia of malignancy; 2)
pathogenesis, diagnosis and therapy of parathyroid disorders,
including primary or secondary hyperparathyroidism; 3) effects of
parathyroid hormone (PTH), parathyroid hormone related protein
(PTHrP), calcitonin, vitamin D, estrogen, retinoic acid, growth
factors (e.g., IGF-I, etc.), glucocorticoids, thyroid hormone and
other systemic or local-acting hormones and their receptors on
bone metabolism; 4) bone active cytokines (e.g., TGF-b, BMPs,
CSF-1); 5) studies of calcium homeostasis, absorption, metabolism,
and excretion, including the calcium activated receptor (CaR); 6)
basic and clinical studies of vitamin D; and 7) bone
morphogenesis, including the roles of developmental factors in
bone formation (e.g., hedgehogs, Hox genes).
The
G-Protein Coupled Receptors Program encompasses studies on
the G-protein coupled receptor superfamily. Specific areas of
support include: 1) cell surface, or seven transmembrane domain
(7-TM), receptors coupled to GTP-binding ("G")- proteins for
signal transduction (e.g., beta-adrenergic receptor); 2) receptor
structure; 3) receptor down-regulation (homologous
desensitization); 4) role(s) of mutated receptors in disease; and
5) coupling of signaling through the receptor to other
membrane-bound effectors and or regulators, such as adenylyl
cyclase, ion channels, protein phosphatases or kinases, and other
receptors. Signal transduction through GPCRs also includes
mechanisms of regulation of gene expression through nuclear
proteins such as the Cyclic Nucleotide Response Element Binding
Protein (CREB) and the CREB binding protein (CBP).
The
Nuclear Hormone Superfamily Program encompasses basic and
clinical research on members of the steroid hormone superfamily
(also known as the nuclear receptor superfamily). The program
includes structure/function studies and the role in signal
transduction and regulation of gene expression of the steroid
hormones (glucocorticoids, mineralocorticoids, progesterone,
estrogens, androgens (testosterone), DHEA) and the nuclear
receptors including thyroid hormone, vitamin D, retinoids (RAR,
RXR, vitamin A), PPARs, and orphan receptors (LXR, Nur77, COUP-TF,
and others). Topics covered include receptor structure,
interaction with cytoplasmic chaperones (e.g., Hsp90, Hsp70,
etc.), interaction with ligand, nuclear translocation, binding to
hormone response elements, interaction with nuclear accessory
proteins (e.g., SRC-1, N-CoR, CBP, histone acetylase/deacetylase,
GRIP1, etc.), and regulation of gene expression.
The
Neuroendocrinology Program encompasses research on
neuropeptides of the hypothalamus. Specific areas of research
support include: 1) physiological response to stress through the
hypothalamic-pituitary-adrenal axis; 2) neuropeptides and
neuropeptide receptor signaling pathways; 3) gene regulation in
the hypothalamus and pituitary gland; 4) diseases of the pituitary
including neoplasia; 5) hypopituitary dwarfism; 6) identification
and characterization of novel hypothalamic or pituitary hormones;
7) tissue specific and developmental expression of pituitary and
hypothalamic genes; 8) pituitary hormone receptors and actions on
target tissues (e.g., GH IGF-1 axis); 9) neuropeptide receptors in
diagnosis and treatment of disease; and 10) neuroendocrine-immune
interactions.
The Regulation of Energy Balance and Body
Composition Program encompasses research on regulation of body
composition by the hypothalamus and circulating factors. Specific
areas of support include: 1) endocrinology of body composition
including interactions between nutrition, exercise, and anabolic
hormones; 2) neuropeptides and their receptors involved in
regulatory pathways controlling feeding behavior, satiety, and
energy expenditure; 3) interactions between hypothalamicpituitary
adrenal axis and peripheral metabolic signals (for example,
insulin), leptin, glucocorticoids); 4) hormones and cytokines
involved in wasting syndromes (cancer, AIDS); 5) endocrine
regulation of energy balance via uncoupling proteins; and 6)
hypothalamic integration of peripheral endocrine and metabolic
signals.
The Nonautoimmune Thyroid Disease Research
Program is focused on normal thyroid physiology and
non-autoimmune thyroid disease. Specific areas of research focus
on: the physiologic regulation of the expression, processing, and
secretion of thyroid hormones; dysfunctional regulation of thyroid
hormones that results in disease; the etiology, pathogenesis,
diagnosis, and therapy of thyroid disorders; the deiodinase
enzymes that convert inactive thyroid hormone to active hormone;
and neural cells that are targets of regulation by and feedback to
the thyroid.
The Steroid Metabolism Program
includes the biochemistry, molecular biology, intermediary
metabolism, function and structure of steroids and similar
molecules derived from cholesterol, including sex steroids and
other hormones (glucocorticoids, mineralocorticoids), retinoids,
cardiac glycosides, prostaglandins and eicosanoids, and bile
acids. Structural and functional studies of the heme proteins,
like mitochondrial cytochromes and cytochrome P450 are included in
this program. It can also include enzyme structure and biology in
activated nitrogen and oxygen species metabolism (nitric oxide,
superoxide, hydrogen peroxide, and antioxidant enzymes).
The Mouse Metabolic Phenotyping Program contains a
consortium of centers with the purpose of phenotyping mouse models
of diabetes and its complications, obesity, or other chronic
metabolic diseases. It will include the development of new tests
for phenotyping mice, adaptation or miniaturization of existing
tests, as well as the performance of these tests to more fully
characterize new or existing models of disease. Emphasis is placed
on non-invasive or minimally invasive technologies that can be
used for longitudinal studies, but this program also includes
high-throughput metabolic screens. Examples include glucose and
insulin clamps, miniaturized assays for hormones, cytokines,
nutrients or intermediary metabolites, kinetic measures of
metabolic processes, immunological parameter, measurements of
energy balance, body composition and activity, measures for
metabolic, behavioral and physiologic abnormalities during disease
progression.
The Developmental Biology Program
includes grants dealing with developmental genetic screens for
identifying mutations that affect the formation of tissue such as
bone, adipose, endocrine pancreas or pituitary and grants dealing
with signals, signaling pathway components and transcriptional
factors that regulate pattern formation in the embryo, or control
the fate, specifications, proliferation and differentiation of
cells in the formation of tissues and organs.
The
Intracellular Signal Transduction Research Program
encompasses research aimed at understanding the structure and
function of intracellular signal transducing molecules. Specific
areas of support include: 1) intracellular kinases, phosphatases
and anchoring proteins; 2) signaling mechanisms that have altered
activity in response to protein phosphorylation, Ca++ and cAMP; 3)
approaches to solving the three-dimensional structure of signaling
proteins including crystallography and NMR; 4) functional analysis
of these proteins including comparison of wild-type and naturally
occurring or synthetic, mutant proteins or expression of
dominant-negative forms of the proteins; 5) microscopic techniques
to localize these proteins within cells; 6) the identification of
substrates for these signaling proteins; and 7) the analysis of
crosstalk among distinct signal transduction pathways.
The Hormone Distribution Program of the
NIDDK makes available to the research community human and animal
pituitary hormones, antisera to these hormones, and selected other
hormonal and biological products. Currently, approximately 180
research materials are distributed through the National Hormone
and Pituitary Program. Most of the products are unavailable
commercially. Approximately 7,000 individual vials of human and
animal hormones and antisera are awarded annually to investigators
for immunochemical research. Frozen human pituitaries and rat
hypothalami are also available for distribution to scientists
attempting to isolate or characterize novel hormones and peptides
or variants. Information about the distribution of these resources
may be obtained from the Pituitary Hormones & Antisera
Program.
Metabolic Diseases Research Programs
The Gene Therapy and Cystic Fibrosis Centers
Program supports three types of centers: Gene Therapy Centers
(P30), Cystic Fibrosis Research Center (P30), and Specialized
Centers for Cystic Fibrosis Research (P50). Gene Therapy Centers
provide shared resources to a group of investigators to facilitate
development of gene therapy techniques and to foster
multidisciplinary collaboration in the development of clinical
trials for the treatment of cystic fibrosis and other genetic
metabolic diseases. Cystic Fibrosis Research Centers (P30) and
Specialized Centers for Cystic Fibrosis Research (P50) provide
resources and support research on many aspects of the pathogenesis
and treatment of cystic fibrosis.
The Cystic Fibrosis
Research Program supports investigator-initiated research
grants encompassing both fundamental and clinical studies of the
etiology, molecular pathogenesis, pathophysiology, diagnosis, and
treatment of cystic fibrosis and its complications. Particular
areas of emphasis of the program include: 1) characterization of
the cystic fibrosis gene, its mutations, and the molecular
mechanisms by which mutations cause dysfunction; 2) studies of the
cystic fibrosis transmembrane regulator (CFTR) protein encoded by
the cystic fibrosis gene, including its processing, trafficking,
and folding, and the mechanisms by which mutations alter CFTR
trafficking and structure/function; 3) elucidation of the pathways
of electrolyte transport in affected epithelia and the
relationship between CFTR and other epithelial ion channels; 4)
elucidation of the potential roles of CFTR in transport of
molecules other than chloride, posttranslational processing of
mucins and other proteins, exocytosis and recycling of cell
membranes, subcellular organelle function, and other cellular
processes; 5) studies of the relationship between genotype and
phenotype in cystic fibrosis and identification of genetic or
environmental factors which explain the variable clinical
presentations and severity of disease; 6) delineation of the
mechanisms underlying the inflammation and infection
characteristic of cystic fibrosis and how mutations in the cystic
fibrosis gene and alterations in CFTR function result in
inflammation and infection; 7) research on other clinical
manifestations of cystic fibrosis, including the pathophysiologic
mechanisms underlying malnutrition and growth failure, impaired
fertility, liver disease, and overall physical and psychosocial
development, and approaches to ameliorate the complications of
cystic fibrosis; 8) development of potential therapeutic
approaches to modulating the transport defect in cystic fibrosis
and to stabilize mutant CFTR and enhance its targeting and
integration into the cell membrane; 9) development of safe and
effective methods for gene therapy; 10) development of animal or
cell models useful for study of cystic fibrosis and its therapy;
and 11) evaluation of therapeutic interventions in cystic fibrosis
in clinical studies or animal models.
The Gene Therapy
Program encompasses research aimed at developing basic and
applied gene therapy for genetic metabolic diseases. Specific
areas of support include: 1) pilot and feasibility studies (R21)
to improve gene delivery systems; 2) studies of the basic science
of AAV, adenovirus, retrovirus and lentivirus vectors; 3) studies
of non-viral methods of gene transfer such as liposomes or
DNA-conjugates; 4) studies to target gene delivery to specific
cell types; and 5) gene therapy of stem cells to treat a genetic
metabolic disease.
The Inborn Errors of Metabolism
Program encompasses research in the pathophysiology and
treatment of genetic metabolic diseases. Specific areas of support
include: 1) studies of etiology, pathogenesis, prevention,
diagnosis, pathophysiology, and treatment of these diseases; 2)
characterization of the genes, gene defects and regulatory
alterations that are the underlying causes of these diseases; 3)
studies of the mutant enzyme and its effect on the structure and
function of the protein 4) the development of animal models for
genetic disease; 5) development and testing of dietary,
pharmacologic and enzyme replacement therapies; and 6) development
of stem cell transplantation both prenatally and postnatally as a
treatment for metabolic diseases.
The Metabolic
Complications of HIV Program encompasses research on the
endocrine and body composition abnormalities associated with HIV
infection and its treatment.
Specific areas of support
are:
- Studies of hormones and cytokines involved in wasting
syndrome.
- Studies of changes in body composition in HIV patients.
- Studies of abnormalities of insulin sensitivity (and other
components of the "Metabolic Syndrome" or "Syndrome X") in
patients with HIV.
The Protein
Trafficking/Secretion/Processing Research Program encompasses
research aimed at understanding the mechanisms that account for
the fate of proteins after their initial translation. Specific
areas of support include: 1) protein folding; 2)
post-translational modifications and the enzymes that catalyze
them; 3) the movement of proteins in vesicles from the endoplasmic
reticulum (ER) through the golgi and endosomes and their ultimate
secretion; 4) mechanisms that account for vesicle formation
(pinching off) and vesicle fusion which are paramount to
understanding trafficking; 5) the movement of proteins in the
direction opposite of secretion, including endocytosis and
retrograde transport; 6) proteins and small molecules that
regulate protein trafficking; and 7) proteasomes, ubiquitin
conjugation, and the N-end rule.
The Molecular and
Functional Imaging Program is comprised of projects that
employ novel molecular and functional imaging techniques to
visualize various aspects of diabetes and obesity, endocrinology,
metabolism and metabolic diseases. The emphasis will be on in
vivo techniques (PET, MRI, Ultrasound, CT, optical tomography,
etc.) with applications serving to tag tissues and cells of
interest; study biological processes in vivo; diagnose
disease; or monitor progress during therapy. These will be studies
either to monitor physiological or metabolic processes, rate of
metabolism, blood flow, sites of hormone action, etc., using
imaging and spectroscopic techniques or to identify cell types
using molecular imaging probes. Another application might be the
technology to develop a probe to identify in vivo the sites within
the hypothalamus that control satiety.
The Proteomics
in Diabetes, Endocrinology and Metabolic Diseases Program is
comprised of grants that study the structure, mechanism, kinetics,
and regulation of isolated purified proteins. This would include
x-ray crystallography, mass spectroscopic, electron microscopic,
nuclear magnetic resonance, and mutational studies of structure.
It would include studies of subunit interactions and interactions
with small regulatory ligands, substrates, intermediates, and
products. Of special interest are new technologies for structure
determination (especially membrane proteins), crystallization,
identification of interacting molecules and proteins, and
assignment of function to unknown gene products of interest to the
fields of diabetes, endocrinology and metabolic diseases. High
throughput methods are highlighted. All informatics associated
with the field of proteomics are included.
The
Metabolism and Insulin Resistance Program is comprised of
grants that study intermediary metabolism and physiology on the
whole body, organ, and cell level. These studies can be done in
vivo, in isolated tissues or in cell culture. They have as a
focus flux and regulation of either a single metabolic pathway,
interacting pathways in a cell or organ, or interactions between
organs in the whole body. Especially important are in vivo
measurements of whole body flux, such as glucose production or
turnover, or blood flow. Examples of important goals for these
studies include an understanding of insulin resistance, regulation
of gluconeogenesis and glucose disposal, protein turnover rate and
regulation, cellular and whole body lipid fluxes, interaction
between carbohydrate and lipid metabolism, rate of tricarboxylic
acid cycle flux and energy production in the cell, transcriptional
regulation of important flux regulating enzymes or transporters
for a given pathway, etc.
Division of Digestive
Diseases and Nutrition
This division supports research
related to liver and biliary diseases, pancreatic diseases,
gastrointestinal diseases, including neuroendocrinology, motility,
immunology, and digestion in the GI tract, nutrient metabolism,
obesity, eating disorders, and energy regulation. The division
provides leadership in coordinating activities related to
digestive diseases and nutrition throughout the NIH and with
various other Federal agencies.
Digestive Diseases
Programs
The Acquired Immunodeficiency Syndrome
Program encourages research into the characterization of
intestinal injury, mechanism of maldigestion, and intestinal
mucosal functions, as well as hepatic and biliary dysfunction in
AIDS. In addition, studies are supported on mechanisms of nutrient
dysfunction, nutritional management in the wasting syndrome and
other aspects of malnutrition related to AIDS.
Clinical
Trials in Digestive Diseases. The Clinical Trials in Digestive
Diseases is a prospective study on ten or more patients to
evaluate one or more experimental intervention(s) in comparison
with a standard treatment and/or placebo control among comparable
groups of patients. Experimental interventions may include
pharmacologic, nonpharmacologic, and behavioral interventions
given for disease prevention, prophylaxis, diagnosis, or therapy.
Areas of emphasis include nonalcoholic steatohepatitis (NASH);
chronic hepatitis C; Helicobacter pylori; primary biliary
cirrhosis; adult and adolescent obesity; inflammatory bowel
disease; functional bowel syndrome and constipation; primary
sclerosing cholangitis; pancreatitis; non-ulcer dyspepsia;
prevention, management, and treatment of portal hypertension; and
recurrent liver disease after transplantation. Either pilot
studies or phase III trials may be appropriate. A phase III
clinical trial usually involves several hundred or more comparable
human subjects. The aim of the trial is to provide evidence for
support of, or a change in, health policy or standard of care.
The Digestive Diseases and Nutrition Epidemiology and
Data Systems was authorized by P.L. 99-158 for the collection,
storage, analysis, retrieval, and dissemination of data derived
from patient populations with digestive diseases and, where
possible, data involving general populations to detect individuals
with a risk of developing digestive diseases. The program
emphasizes determining environmental and genetic risk factors,
outcomes, and the public health impact of digestive and
nutritional disorders.
The Digestive Diseases Research
Core Centers (DDRCCs) in this program presently focus on liver
diseases, gastrointestinal motility, absorption and secretion
processes, inflammatory bowel disease, structure/function
relationships in the gastrointestinal tract, neuropeptides and gut
hormones, and gastrointestinal membrane receptors.
The
Gastrointestinal Motility Program supports research on
structure and function of gastrointestinal muscles, the
biochemistry of contractile processes and mechanochemical energy
conversion relations between metabolism and contractility in
smooth muscle, extrinsic control of digestive tract motility, and
fluid mechanics of gastrointestinal flow. Areas of interest
include actions of drugs on gastrointestinal motility, intestinal
obstruction, and diseases such as irritable bowel syndrome,
colonic diverticular disease, swallowing disorders, and
gastroesophageal reflux.
The Gastrointestinal Mucosa
and Immunology Program. Research focuses on intestinal
immunity and inflammation. Areas include: ontogeny and
differentiation of gut-associated lymphoid tissue; migratory
pathways of intestinal lymphoid cells; humoral antibody responses;
cell-mediated cytotoxic reactions; genetic control of the immune
response at mucosal surfaces; immune response to enteric antigens
in both intestinal/extraintestinal sites; granulomatous
inflammation; lymphokines and cellular immune regulation;
leukotrienes/prostaglandin effects on intestinal immune responses;
T-cell mediated intestinal injury; intestinal mast cells and their
role in inflammation; approaches to optimal mucosal
immunoprophylaxis, including viral, bacterial, and parasitic
diseases; and diseases such as gluten sensitive enteropathy,
inflammatory bowel disease, and gastritis.
The
Gastrointestinal Neuroendocrinology Program supports both
basic and clinical studies on normal and abnormal function of the
enteric nervous system and the central nervous system elements
that control the enteric nervous system. Research focuses on
gastrointestinal hormones and peptides and studies on disease
conditions associated with excessive or deficient secretions of
neuropeptides.
The Gastrointestinal Transport and
Absorption Program supports research on the process of food
digestion in the gastrointestinal tract (GIT). Areas of research
focus on the regulation of gene expression in the GIT; structure
and function of the gut mucosa; cytoskeletal structure and
contractility in brush border; growth and differentiation of
gastrointestinal cells in normal and disease states; intestinal
transplantation, storage, and preservation; and gastrointestinal
tissue injury, repair, and regeneration.
The Liver and
Biliary Program supports basic and clinical research into the
normal function and the diseases of the liver and biliary tract.
Areas of study include: Neurohormonal factors involved in the
regulation of hepatic and biliary function, studies on receptors,
and intracellular signal transducing pathways involved in hepatic
response to different etiological factors; Post-translational
mechanisms that account for the fate of proteins.
Studies
of the biochemistry, etiology, pathogenesis, genetics, diagnosis,
treatment and prevention of disorders of the liver and biliary
tract, including chronic liver diseases and its sequelae, and
liver diseases during pregnancy.
Studies on the natural
history of infectious hepatitis, particularly viral Hepatitis C
and B, its epidemiology, risk factors, preventive and therapeutic
intervention; Studies on the interrelation of alcohol, viral
hepatitis, HIV infections in the course of chronic liver diseases,
cirrhosis and hepatic cancers; Basic and clinical studies on the
etiology, molecular pathogenesis, pathophysiology, diagnosis, and
treatment of hereditary liver diseases and its complications.
Special emphasis is on characterization of the genes, gene defects
and regulatory alterations that are the underlying causes of these
diseases.
Developing an understanding of the basic
underlying concepts and methodologies for gene therapy its
application to the treatment of genetic liver diseases;
Developmental of experimental models relevant of liver diseases;
Studies on the isolation, characterization, culture of viable
hepatocytes and stem cells for cell bioengineering and
transplantation as support therapies for acute and chronic liver
diseases.
The Pancreas Program encourages research
into the structure, function, and diseases (excluding cancer and
cystic fibrosis) of the exocrine pancreas. Research efforts focus
on: Neurohormonal factors involved in the regulation of pancreatic
exocrine function in response to pathophysiological stimuli;
Studies on receptor and function of intra-cellular signal
transducing molecules, coupling to downstream effectors;
Compartmentalization of enzymes, substrates, and their effectors;
Understanding post-translational mechanisms that account for the
fate of proteins, including folding, trafficking and secretion.
Understanding the properties and functions of intracellular and
extracellular filamentous suprastructures that are involved in
hormone signaling and exocrine pancreatic function.
Studies on the biochemistry, etiology, pathogenesis,
genetics, epidemiology, diagnosis, treatment and prevention of
disorders of the exocrine pancreas; Development of experimental
models; Studies relating to development of the exocrine pancreas
including the growth and differentiation factors involved in this
process and the characterization, isolation, production and uses
of pancreatic stem cells; Studies on organ collection,
preservation and transplantation.
The Genetics and
Genomics of Digestive Diseases supports research on
identification of genes influencing predisposition to diseases of
the gut, liver, and exocrine pancreas, as well as studies of
control of gene expression during normal development and disease
states of these organs.
Epidemiology and Clinical
Trials Programs
The Clinical Trials Program in
Digestive Diseases. The Clinical Trials in Digestive Diseases
is a prospective study on ten or more patients to evaluate one or
more experimental intervention(s) in comparison with a standard
treatment and/or placebo control among comparable groups of
patients. Experimental interventions may include pharmacologic,
nonpharmacologic, and behavioral interventions given for disease
prevention, prophylaxis, diagnosis, or therapy. Areas of emphasis
include non-alcoholic steatohepatitis (NASH); chronic hepatitis C;
Helicobacter pylori; primary biliary cirrhosis; adult and
adolescent obesity; inflammatory bowel disease; functional bowel
syndrome and constipation; primary sclerosing cholangitis;
pancreatitis; non-ulcer dyspepsia; prevention, management, and
treatment of portal hypertension; and recurrent liver disease
after transplantation. Either pilot studies or phase III trials
may be appropriate. A phase III clinical trial usually involves
several hundred or more comparable human subjects, the aim of the
trial being to provide evidence for support of, or a change in,
health policy or standard of care.
The Clinical Trials
Program in Obesity/Nutrition. This program includes
prospective studies in nutrition and obesity that involve ten or
more patients. In these studies, two forms of treatment, one which
could be placebo or standard care, are to be compared. Areas of
emphasis include adult and adolescent obesity, and nutrition areas
such as eating disorders and wasting.
Either pilot studies
or phase III trials may be appropriate. A phase III clinical trial
usually involves several hundred or more comparable human
subjects. The aim of the trial is to provide evidence for support
of, or a change in, health policy or standard of care.
The
Epidemiology and Data Systems Program was authorized by
P.L. 99-158 for the collection, storage, analysis, retrieval, and
dissemination of data derived from patient populations with
digestive diseases and, where possible, data involving general
populations to detect individuals with a risk of developing
digestive diseases. The program emphasizes determining
environmental and genetic risk factors, outcomes, and the public
health impact of digestive and nutritional disorders.
Digestive Diseases and Nutrition Epidemiology and Data
Systems was authorized by P.L. 99-158 for the collection,
storage, analysis, retrieval, and dissemination of data derived
from patient populations with digestive diseases and, where
possible, data involving general populations to detect individuals
with a risk of developing digestive diseases. The program
emphasizes determining environmental and genetic risk factors,
outcomes, and the public health impact of digestive and
nutritional disorders.
Look AHEAD: Action for Health in
Diabetes is a clinical trial recruiting 5000 obese individuals
with type 2 diabetes into an 11.5 year study that will investigate
the long term health consequences of interventions designed to
achieve and sustain weight loss. The primary outcome of the trial
is cardiovascular events: heart attack, stroke and cardiovascular
death. The study also will examine impact of the interventions on
cardiovascular risk factors, diabetes control, cost effectiveness,
quality of life, and a number of additional measures. The Obesity
Special Projects program also administers ancillary studies to
Look AHEAD.
Nutritional Sciences Programs
Clinical Nutrition Research Units (CNRU). The CNRU
is an integrated array of research, educational, and service
activities focused on human nutrition in health and disease. It
serves as the focal point for an interdisciplinary approach to
clinical nutrition research and for the stimulation of research in
improved nutritional support of acutely and chronically ill
persons, assessment of nutritional status, effects of disease
states on nutrient needs, and effects of changes in nutritional
status on disease.
The Clinical Trials Program in
Digestive Diseases. The Clinical Trials in Digestive Diseases
is a prospective study on ten or more patients to evaluate one or
more experimental intervention(s) in comparison with a standard
treatment and/or placebo control among comparable groups of
patients. Experimental interventions may include pharmacologic,
nonpharmacologic, and behavioral interventions given for disease
prevention, prophylaxis, diagnosis, or therapy. Areas of emphasis
include non-alcoholic steatohepatitis (NASH); chronic hepatitis C;
Helicobacter pylori; primary biliary cirrhosis; adult and
adolescent obesity; inflammatory bowel disease; functional bowel
syndrome and constipation; primary sclerosing cholangitis;
pancreatitis; non-ulcer dyspepsia; prevention, management, and
treatment of portal hypertension; and recurrent liver disease
after transplantation. Either pilot studies or phase III trials
may be appropriate. A phase III clinical trial usually involves
several hundred or more comparable human subjects. The aim of the
trial is to provide evidence for support of, or a change in,
health policy or standard of care.
The Clinical Trials
Program in Obesity/Nutrition. This program includes
prospective studies in nutrition and obesity that involve ten or
more patients. In these studies, two forms of treatment, one which
could be placebo or standard care, are to be compared. Areas of
emphasis include adult and adolescent obesity, and nutrition areas
such as eating disorders and wasting.
Either pilot studies
or phase III trials may be appropriate. A phase III clinical trial
usually involves several hundred or more comparable human
subjects. The aim of the trial is to provide evidence for support
of, or a change in, health policy or standard of care.
The
Nutrient Metabolism Program supports basic and clinical
studies related to the requirement, bioavailability, and
metabolism of nutrients and other dietary components. Specific
areas of research interest include understanding of physiological
function and mechanism of action/interaction of nutrients within
the body; effects of environment, heredity, stress, drug use,
toxicants, and physical activity on problems of nutrient imbalance
and nutrient requirements in health and disease; and specific
metabolic considerations relating to alternative forms of nutrient
delivery and use such as total parenteral nutrition. The program
also supports research to improve methods of assessing nutritional
status in health and disease.
The Obesity and Eating
Disorders Program emphasizes support of investigatorinitiated
basic and clinical research relating to biomedical and behavioral
aspects of obesity and eating disorders including anorexia
nervosa, bulimia nervosa, and binge eating disorder. This research
seeks to establish a clear understanding of the etiology,
prevention, and treatment of these multifaceted conditions. Areas
of research interest include investigations of molecular,
physiological, metabolic, neuroendocrine, psychological,
epidemiologic, and genetic factors that affect food choices, food
intake, eating behavior, appetite, satiety, body composition,
nutrient partitioning, and energy regulation. Studies include the
effects of taste, smell, and gastric and humeral response in
association with dietary intake and subsequent behavior. The roles
of neural and hormonal factors, including leptin and its
receptors, melanocortins and their receptors, Agouti-related
peptide, MCH, urocortin, CRH, NPY, CART, orexin, CPE, and others
from the molecular to the whole animal/human level are encompassed
within this program if the primary goal of the investigations is
to examine their role in the development or maintenance of
obesity. The physiological and metabolic consequences of weight
loss or weight gain, the effect of exercise on appetite and weight
control, and the individual variability in energy utilization and
thermogenesis (including the role of the uncoupling proteins and
beta 3 adrenergic receptors in energy regulation) are contained
within the specific research interests of this program. In
addition, endocrine, metabolic, dietary, and other genetic and
environmental determinants of the proliferation and control of
adipocyte size, deposition and number, and the responsiveness of
the adipocyte to various metabolic and pharmacological stimuli as
they relate to the development of obesity are also specific
topics. Investigations incorporating improved methods for
assessment of body composition, examination of health risk factors
with specific degrees of obesity or body composition, and
determination of the effect of exercise on body composition also
are supported.
The Obesity Special Projects Program
administers the clinical trial Look AHEAD: Action for Health in
Diabetes. Look AHEAD is recruiting 5,000 obese individuals
with type 2 diabetes into an 11.5-year study that will investigate
the long-term health consequences of interventions designed to
achieve and sustain weight loss. The primary outcome of the trial
is cardiovascular events: heart attack, stroke and cardiovascular
death. The study also will examine impact of the interventions on
cardiovascular risk factors, diabetes control, cost effectiveness,
quality of life, and a number of additional measures. The Obesity
Special Projects program also administers ancillary studies to
Look AHEAD that were awarded under the RFA DK-00-017. Look AHEAD
may potentially accept additional ancillary studies submitted as
investigator-initiated applications, if they are approved in
advance by the Look AHEAD Sub-studies and Ancillary Studies
Committee to ensure that they do not impose an excessive burden on
Look AHEAD participants or staff.
Obesity/Nutrition
Research Center (ONRC). The ONRCs encourage collaboration
among researchers and a multidisciplinary approach to the
treatment and prevention of obesity. They will help to capitalize
on emerging research opportunities in obesity and to enhance the
translation of research findings to the public.
U.S. -
Japan Malnutrition Panel. In 1965 President Lyndon B. Johnson
and Japanese Prime Minister Eisaku Sato issued a joint communiquι
recognizing their mutual concern for the health and well being of
all peoples of Asia. This led to the formation of the U.S.-Japan
Cooperative Medical Science Program, which operates within a
bilateral government framework. The malnutrition panel was
established in 1966 to foster and support investigator-initiated
research to help alleviate the serious problem of malnutrition.
Current topics of importance to the United States and
Japan focus on consequences of changing dietary patterns on
health, development of disease, and disease prevention. Specific
research includes topics related to obesity and its co-morbidities
with emphasis on the impact of body composition and regional
deposition of adipose tissue on the development of physiologic
abnormalities.
The Clinical Trials in Obesity/Nutrition
Program includes prospective studies in nutrition and obesity,
which involve ten or more patients. In these studies, two forms of
treatment, one of which could be placebo or standard care, are to
be compared. Areas of emphasis include adult and adolescent
obesity, and nutrition areas such as eating disorders and wasting.
The Obesity Prevention and Treatment Program is
designed to support research that focuses on the prevention and
treatment of overweight and obesity in human populations.
Prevention includes primary and secondary approaches to prevent
the initial development of overweight/obesity through control of
inappropriate weight gain and increases in body fat; weight
maintenance among those at risk of becoming overweight, and
prevention of weight regain once weight loss has been achieved.
Treatment includes clinical trials evaluating approaches to lose
weight or maintain weight loss, including, but not limited to,
behavioral, pharmacological, and surgical approaches. This program
also includes environmental-, policy-, and population-based
approaches to the prevention and/or treatment of obesity.
Division of Kidney, Urologic and Hematologic Diseases
The division supports research on diseases of the
kidney, genitourinary tract, and blood and blood-forming organs,
and on the fundamental biology relevant to these organ systems. It
funds training and professional development of investigators in
disciplines critical for research in these areas.
Kidney Research
The Basic Renal Biology
Program supports research on normal development, structure and
function of the kidney. Areas of emphasis include glomerular
function and cell biology, transport physiology and
structure-function analysis of transport proteins, and integrated
regulation of solute and water excretion. The program supports
investigation of adverse effects of nephrotoxic drugs and
environmental toxins and mechanisms of hypoxic renal cell injury.
A major area of strength is studies examining
intracellular signal transduction for renal hormones and growth
factors. In addition to study on mammalian systems, investigation
is supported on transport function and development and genomic
analysis of membrane transport proteins using simple systems such
as bacteria C. elegans and zebrafish.
The
Chronic Renal Diseases Program supports basic and clinical
studies on the etiology, prevention, diagnosis and treatment of
chronic renal diseases. Disease categories receiving particular
emphasis include analgesic nephropathy, polycystic kidney disease,
diabetic nephropathy, glomerulonephritis and other immune
disorders of the kidney, hypertensive nephrosclerosis and HIV
nephropathy. A major interest in this program is renal diseases
that affect children and the effects of chronic renal
insufficiency on growth and development of children.
The
End-Stage Renal Disease Program supports investigation on
the pathogenesis of the uremic state, on end-stage renal disease
treatment by peritoneal and hemodialysis, and on nutrition in
renal disease. Investigation on renal transplantation is supported
with particular emphasis on nonimmunological renal injury and on
methods of increasing organ availability, particularly in minority
populations.
The Diabetic Nephropathy Program
supports investigation into the pathogenesis, prevention and
treatment of the kidney disease associated with diabetes mellitus.
One major area of emphasis is the identification of genes
associated responsible for the familial clustering of diabetic
kidney disease, through sponsorship of the FIND consortium.
The Pediatric Nephrology Program supports basic and
clinical research on the causes, treatments, and prevention of
kidney diseases of children. Research efforts focus on inherited
and congenital renal diseases; kidney disease of diabetes
mellitus; IgA nephropathy; and kidney disease and hypertension,
which starts in early childhood.
The Renal Epidemiology
Program Investigation into the incidence and prevalence of
renal diseases, the factors associated with increased mortality
and co-morbidity and cost-benefit assessment of prevention and
treatment strategies are areas supported through the renal
epidemiology program.
The U.S. Renal Data System
(USRDS), an information resource for the epidemiology of
end-stage renal disease, is supported through this program. USRDS
investigation of cost factors in dialysis care is co-funded with
the Centers for Medicare and Medicaid Services, formerly known as
the Health Care Financing Administration.
Urology
Research
The Basic Urology Program supports
basic research on the normal and abnormal development, structure
and function of the genitourinary tract. A major area of interest
is investigation of the biology of bladder cells, including
studies on transport properties, effects of obstruction on
patterns of protein expression and examination of interactions
between urinary pathogens and cells of the urinary tract. The
program on prostate biology has particular strengths in
investigation of prostate cell growth and mechanisms of growth
factor signal transduction.
The Clinical Urology
Program The mission of this program is research that will
increase the knowledge of etiology, diagnosis, pathophysiology,
therapy and prevention of major pediatric and adult urological
disorders. Non-malignant disorders of the bladder and prostate,
including benign prostatic hyperplasia, interstitial cystitis,
urinary tract infections, urinary incontinence and urolithiasis
are areas of emphasis, as are the effects of systemic diseases
such as diabetes mellitus, spinal cord injury, and multiple
sclerosis on these organs. In addition, the program supports
studies of diagnostic and therapeutic modalities such as 1)
shock-wave and laser lithotripsy, 2) urolithiasis inhibitors, 3)
bladder substitution procedures and devices, and 4) prostate
growth inhibitor and reduction therapies.
The Urologic
Diseases Epidemiology Program The major emphasis of this
program is to develop a source of epidemiological information that
may further understanding of natural history, risk factors and
health resource utilization for urologic conditions. Plans are to
collect and analyze new and existing data on incidence,
prevalence, morbidity, mortality and health resource utilization
associated with various urologic conditions of high public health
importance. The information will be presented in a planned
publication tentatively titled "Urologic Diseases in America."
Hematology Research
The Hematology
Program supports research into the fundamental processes
underlying the normal and pathologic function of blood cells and
the reticuloendothelial system. Major areas of interest include
the genetic regulation of hemoglobin and other proteins of the
blood; acquired and inherited anemias; cell membrane composition
and regulatory processes; iron metabolism, storage, and transport;
hematopoiesis and its regulation by growth factors, including
erythropoietin; transcription and signaling factors such as the
JAK/STAT pathway involved in hematopoietic cell differentiation;
immunohematology; hematopoiesis, hematopoietic stem cell biology,
and the expression of differentiation potential of hematopoietic
stem cells; stem cell plasticity and the cellular, molecular, and
genetic mechanisms that allow cells to express plasticity.
Emphasis is on the application of fundamental knowledge to current
issues such as gene transfer therapy and bone marrow
transplantation, and disorders such as sickle cell anemia,
thalassemia, hemochromatosis, iron deficiency anemia,
thrombocytopenia and hemolytic anemia.
The Chelator
Therapy Program Research is supported on the development of
new iron chelating drugs for the treatment of transfusion iron
overload, such as in Cooley's anemia, sickle cell disease, and
other instances of iron overload. A safe and inexpensive orally
active iron chelator that effectively promotes iron excretion is
needed urgently, since the only currently available drug,
desferrioxamine B, is expensive and is painful and cumbersome to
administer, leading to widespread non-compliance among the young
adult patient population. Pre-clinical toxicity studies of
potential iron chelating drugs are performed under the contract
mechanism. Grant support is offered for basic research on the
kinetics of iron chelation, the identity of the iron pools
addressed, and ways to enhance the chelating activity and reduce
the toxicity of known iron chelators.
The Hematopoietic
Lineage Genomics Anatomy Program This program has been
initiated to merge the fields of hematopoietic cell biology,
including erythroid cell physiology, with bioinformatics. The
combination of these two fields will: 1) advance the ability to
catalog and monitor genes that are expressed during normal and
variant hematopoietic cell differentiation, 2) facilitate a more
comprehensive understanding of the dynamics of molecular events
that occur during differentiation, and most importantly, 3)
develop a quantitative model that incorporates known gene
expression data into a description of a red blood cell. This model
could then be used to test novel expression patterns as they are
discovered and also be used as a scaffold from which to devise
models for other tissue and organ development.
Genomics
Research
The Genomics Research Program
encompasses research on genomics and related technologies in the
study of kidney, genitourinary tract, and blood and blood-forming
organs. This program also supports model organism genomics
research, including the development of genetic tools for
high-throughput functional genomics studies. One major
programmatic area is the leadership of a major trans-NIH
initiative to develop genomics of zebrafish, Danio rerio.
Office of the Director
Office of
Minority Health Research Coordination. To address the burden
of diseases and disorders that disproportionately impact the
health of minority populations, the Director of the NIDDK created
the NIDDK Office of Minority Health Research Coordination (OMHRC).
The OMHRC will help implement the Institute's strategic plan for
health disparities and build on the strong partnership with the
National Center on Minority Health and Health Disparities at NIH.
For more information, please contact: Office of Minority Health
Research Coordination, 6707 Democracy Boulevard, Suite 901/933,
Bethesda, MD 20892, phone: (301) 435-2988.
Advisory
Council
National Task Force on Prevention and
Treatment of Obesity. The task force was established in June
1991 to synthesize current scientifically based information on the
prevention and treatment of obesity and to develop statements
about topics of clinical importance that are based on critical
analyses of the literature. It is composed of leading obesity
researchers and clinicians who advise the institute on research
needs and sponsor workshops on topics related to the prevention
and treatment of obesity. Organizationally, it is placed under the
auspices of the NIDDK Advisory Council.
Health
Information and Education Services
National
Diabetes Information Clearinghouse (NDIC) National Digestive
Diseases Information Clearinghouse (NDDIC) National Kidney and
Urologic Diseases Information Clearinghouse (NKUDIC)
The three clearinghouses serve as information resources
for patients, the public, and health professionals concerned with
diabetes, digestive diseases, and kidney and urologic diseases.
Each was authorized by Congress to increase knowledge and
understanding about these areas through the effective
dissemination of information. The NDIC was authorized by Congress
in 1976, the NDDIC in 1980, and the NKUDIC in 1987.
The
clearinghouses answer inquiries; develop, print and distribute
publications; and work closely with professional and
patient-advocacy organizations and U.S. Government agencies to
coordinate informational resources about diabetes, digestive
diseases, and kidney and urologic diseases.
The
clearinghouses also develop and maintain relevant sections of the
Combined Health Information Database a free, online
bibliographic database of references to books, journal articles,
audiovisuals, directories, bibliographies, manuals, product
descriptions, brochures and pamphlets, computer programs,
monographs, newsletters, and other educational materials (http://chid.nih.gov/).
Addresses are:
NDIC, 1 Information Way, Bethesda,
MD 20892-3560 phone: 1-800-860-8747;
NDDIC, 2
Information Way, Bethesda, MD 20892-3570 phone:
1-800-891-5389;
NKUDIC, 2 Information Way, Bethesda, MD
20892-3580 phone: 1-800-891-5390.
National Diabetes
Education Program (NDEP)
The NDEP is sponsored
by the NIDDK of the NIH and the Division of Diabetes Translation
of the CDC and over 200 public and private organizations. The
program's goal is to improve the treatment and outcomes for people
with diabetes, to promote early diagnosis, and ultimately to
prevent the onset of diabetes. The program's goal and objectives
support a major Federal Government public health initiative,
Healthy People 2010, which has established health objectives for
reducing the burden of diabetes in the first decade of the 21st
century. NDEP program audiences include people with diabetes and
their families, with special emphasis on racial ethnic populations
disproportionately affected by diabetes, health care providers,
payer and purchasers of health care and health care systems, and
the general public, including those people who are undiagnosed and
people at risk for the disease.
NDEP publications are
available through the NDEP home page at http://ndep.nih.gov/. The
mailing address is 1 Diabetes Way, Bethesda, MD 20892-3600, phone
800-438-5383.
National Kidney Disease Education Program
(NKDEP)
The NKDEP is a program of the National
Institute of Diabetes and Digestive and Kidney Diseases to address
the growing problem of kidney disease in this country and to
reduce the morbidity and mortality caused by kidney disease and
its complications. The program will raise awareness about the
seriousness of kidney disease, the importance of prevention, early
diagnosis and appropriate management of kidney disease, and the
prevention and management of complications.
Weight-Control Information Network (WIN)
The Weight-control Information Network (WIN) is a national
information service of the National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK), National Institutes of
Health (NIH). WIN was established in 1994 to provide health
professionals and consumers with science-based information on
obesity, weight control, and nutrition. WIN has also developed the
Sisters Together: Move More, Eat Better Media program that
encourages Black women 18 and over to maintain a healthy weight by
becoming more physically active and eating healthier foods.
WIN publications are available through the WIN home
page at http://www.niddk.nih.gov/health/nutrit/nutrit.htm
The mailing address is 1 WIN Way, Bethesda, MD 20892-3665, phone
1-877-946-4627.
NIDDK Appropriations Grants and Direct Operations
Fiscal year |
Total grants |
Direct operations |
Total |
(Amounts in thousands of
dollars) |
1954 |
$3,621 |
$3,379 |
$7,000 |
1955 |
4,390 |
3,880 |
8,270 |
1956 |
5,910 |
4,930 |
10,840 |
1957 |
10,290 |
5,595 |
15,885 |
1958 |
13,837 |
6,548 |
20,385 |
1959 |
23,421 |
7,794 |
31,215 |
1960 |
38,553 |
8,309 |
46,862 |
1961 |
50,882 |
10,318 |
61,200 |
1962 |
69,809 |
12,022 |
81,831 |
1963 |
90,011 |
13,377 |
103,388 |
1964 |
99,914 |
13,765 |
113,679 |
1965 |
97,905 |
15,145 |
113,050 |
1966 |
104,393 |
18,810 |
123,203 |
1967 |
113,621 |
22,066 |
135,687 |
1968 |
116,160 |
22,738 |
138,898 |
1969 |
117,953 |
25,934 |
143,887 |
1970 |
118,959 |
27,660 |
146,619 |
1971 |
109,670 |
28,669 |
138,339 |
1972 |
122,309 |
31,016 |
153,325 |
1973 |
134,522 |
32,794 |
167,316 |
1974 |
125,622 |
33,825 |
159,447 |
1975 |
136,011 |
37,503 |
173,514 |
1976 |
138,612 |
40,904 |
179,516 |
1977 |
170,944 |
48,656 |
219,600 |
1978 |
202,719 |
57,534 |
260,253 |
1979 |
238,199 |
64,568 |
302,767 |
1980 |
274,088 |
67,118 |
341,206 |
1981 |
300,943 |
68,519 |
369,462 |
1982 |
296,898 |
71,293 |
368,191 |
1983 |
335,566 |
77,926 |
413,492 |
1984 |
384,080 |
79,946 |
464,026 |
1985 |
453,458 |
86,041 |
539,499 |
1986 |
461,890 |
85,483 |
547,373 |
1987 |
425,062 |
85,818 |
510,880 |
1988 |
442,618 |
91,741 |
534,359 |
1989 |
462,697 |
96,617 |
559,274 |
1990 |
474,455 |
105,529 |
579,984 |
1991 |
500,127 |
115,135 |
615,262 |
1992 |
539,913 |
121,533 |
661,446 |
1993 |
553,838 |
126,676 |
680,514 |
1994 |
598,885 |
125,737 |
715,622 |
1995 |
614,292 |
122,751 |
737,043 |
1996 |
636,295 |
132,058 |
768,353 |
1997 |
674,738 |
138,326 |
813,064 |
1998 |
723,738 |
146,493 |
869,686 |
1999 |
830,573 |
160,498 |
991,071 |
2000 |
954,437 |
185,678 |
1,140,115 |
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