Celebrating the Past, Present, and Future of NIDDK-Supported Research Centers Focused on Diabetes, Endocrinology, and Metabolic Diseases

Abstract

This year marks the 75th anniversary of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health. NIDDK’s long history of research and innovation includes support of four types of collaborative research centers focused on diabetes, endocrinology, and metabolic diseases. The Diabetes Research Centers promote basic and clinical diabetes research, while the Centers for Diabetes Translation Research conduct diabetes research across the translation science spectrum. The Mouse Metabolic Phenotyping Center (MMPC)-Live program provides the research community with standardized phenotyping services for mouse models of diabetes and obesity, and the Cystic Fibrosis Research and Translation Centers advance basic, preclinical, and clinical research for cystic fibrosis. These centers have evolved over time in response to new scientific opportunities and to expand their reach to be an asset to the larger scientific community. Looking to the future, NIDDK will continue to ensure that these centers enhance the research community, foster novel and synergistic scientific collaborations, and promote career development of scientists in the early stages of their careers. We will also ensure that our centers align with NIDDK’s goal of improving health outcomes for all people with and at risk for diseases, within our mission.

Article Highlights

• NIDDK’s research centers focused on diabetes, endocrinology, and metabolism serve broad communities of investigators and address existing research gaps to propel scientific progress.

• The Diabetes Research Centers support basic and clinical research, and the Centers for Diabetes Translation Research support research across the translation science spectrum.

• The MMPC-Live program provides phenotyping services for mouse models of diabetes and obesity, and the Cystic Fibrosis Research and Translation Centers advance basic, preclinical, and clinical research for cystic fibrosis.

• Future goals for the centers include fostering novel and synergistic scientific collaborations, as well as continuing to promote career development.

Introduction

During its 75-year history, the goals of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) have been to improve the quality of life and health of people by conducting and supporting medical research and training and sharing science-based information. NIDDK’s mission is inclusive of some of the most common, consequential, chronic, and costly diseases in the U.S. (Fig. 1). For example, it is estimated that diabetes affects 11.6% of the U.S. population and that 97.6 million people have prediabetes. Furthermore, 1 in 3 Medicare dollars is spent on treating people with diabetes. This article will focus only on those center programs supported by NIDDK’s Division of Diabetes, Endocrinology, and Metabolic Diseases (DEM)—on their activities, impact on the scientific field, collaborations, evolution, and future directions. However, both NIDDK’s Division of Digestive Diseases and Nutrition and Division of Kidney, Urologic, and Hematologic Diseases also support long-standing and impactful center programs, but a review of their history is beyond the scope of this article.

Figure 1.

The burden of diabetes. NIDDK provides considerable funding support to address some of the most common, consequential, chronic, and costly diseases in the U.S. Statistics regarding this burden are shown.

In addition to providing considerable support for individual investigators, NIDDK, through its DEM Division, funds a research infrastructure to serve a broader community through a portfolio of center programs consisting of the Diabetes Research Centers (DRCs), the Centers for Diabetes Translation Research (CDTRs), the Mouse Metabolic Phenotyping Center (MMPC)-Live program, and the Cystic Fibrosis Research and Translation Centers (CFRTCs). Each of these center programs has a unique focus addressing existing research gaps and continuing to evolve to address new opportunities.

The concept for DEM centers dates to the early 1970s, when congressional actions established the first Diabetes Endocrinology Research Centers (DERCs). Other center programs were established by virtue of further congressional actions as well as the recognition by NIDDK that additional center programs were needed to build on rapid research progress and to address emerging scientific opportunities. Today, NIDDK has broad authority for administering its centers programs through the Public Health Service Act (1). A timeline of the establishment of the centers programs discussed in this article can be found in Fig. 2.

Figure 2.

NIDDK centers timeline. The timeframe for the inception of each of the center programs discussed in this article is shown. For context, relevant discoveries in diabetes during this same timeframe are shown at the bottom. NEJM: New England Journal of Medicine publication of article by Koenig et al. (14). ADA, American Diabetes Association; DCCT, Diabetes Control and Complications Trial; FDA, U.S. Food and Drug Administration; NDDG, National Diabetes Data Group.

The DEM centers programs synergize researchers within affiliated institutions, hospitals, and medical centers to address complex scientific questions by supporting research across different fields and programs, and through collaborations both within each center and with other centers. They also develop research resources of value for the larger scientific community and promote career development of the next generation of scientists. Other activities include piloting feasibility research of new investigators; recruiting established investigators into DEM-related fields; supporting core facilities with specialized expertise and equipment that provide technical research services to multiple researchers; offering grantees economies of scale in the creation and use of research protocols, materials, services, and equipment; and promoting research in areas of clinical applications.

DRCs

The DRCs, which began in the early 1970s, are among the longest-running NIDDK-supported programs and have provided key resources for the diabetes research community. NIDDK funded the first Diabetes Endocrinology Centers (later named Diabetes Endocrinology Research Centers [DERCs]) in 1973, followed by awards to establish Diabetes Research and Training Centers (DRTCs) in 1977. DRTCs were like DERCs with an added dissemination research project component that evolved into a “prevention and control core.” The DERC and DRTC programs continued to grow and evolve over the next decades and were combined into the present-day DRC program. Furthermore, NIDDK established a new center program focused on diabetes translational research. (See CDTRs).

The DRCs, located at extramural research institutions that have an established base of high-quality, diabetes-related research, bring together investigators from a variety of scientific disciplines to enhance and extend the effectiveness of their research. DRCs encourage increased, cost-effective collaboration among multidisciplinary groups of investigators via shared access to specialized, state-of-the-art technical resources and expertise. These efforts result in the DRCs serving larger communities beyond the DRC institution(s), while stimulating team science. DRCs span geographically across the U.S. and, in most cases, encompass several affiliated institutions/medical centers/universities/hospitals, thus building a community of diabetes researchers by providing enrichment activities to foster multidisciplinary approaches to diabetes research and to attract new investigators, or established investigators with relevant expertise, to diabetes research. Through these activities, the DRCs have had significant impact on the DEM research community. The reach of the DRC program can be seen at the diabetes centers web page, which shows a map of the affiliated institutions that are part of the 17 currently funded DRCs across the country (https://diabetescenters.org/centers).

Each DRC is focused around three to five scientific themes, ranging from cell signaling, cellular and molecular metabolism, islet function and survival, genetics and immunology of type 1 diabetes, integrated physiology of insulin action, and nutrition and physiology of diabetes and obesity to central regulation of body weight, etiology and pathogenesis of diabetes, and clinical trials and complications of diabetes and obesity, as some examples. The member base of each DRC (to include affiliated and associate members) ranges from 50 to 150 members, depending on the size and outreach capacity of the center. Structurally, the centers consist of an administrative core, a minimum of two and up to six biomedical research cores, and a pilot and feasibility (P&F) program.

The administrative core is expected to ensure the coordination and integration of DRC components and activities, including support of an enrichment program that will build a community of diabetes researchers at a regional and national level.

The biomedical research cores have also evolved over time. For example, the initial DRCs made integral links with the then federally funded General Clinical Research Centers (GCRCs) that supported clinical research at many institutions where DRCs were also funded. These collaborations enhanced both, as many of the DRCs had cores housed within the GCRCs that supported the technologies and assays needed by clinical researchers (e.g., labeled glucose infusions). The biomedical research cores of the DRCs frequently leveraged institutional research cores by supporting use by the center members, as well as by providing support to the cores to develop and disseminate technology. Miniaturized physiological and metabolic technology was starting to be incorporated into DRC cores as genetic mouse models for diabetes were emerging, and the community felt that wider access to these methodologies was important for progress. Thus, as this evolving need was recognized, this direction was the genesis for the new MMPC program. (See MMPC-Live.) Although funding of institutional cores through the DRCs is still allowed, diabetes/endocrinology/metabolic disease–specific cores have priority for funding. Examples include islet and physiology cores, diabetes genomics and analytics cores, and diabetes-specific clinical and translational cores. Descriptions of all DRC biomedical research cores can be found on the diabetes centers web page https://diabetescenters.org/cores.

The DRCs’ P&F program has also had a long-lasting impact in promoting the careers of talented early-stage investigators (ESIs), emerging physician scientists, and those new to the field of diabetes and related areas. Several of the DRCs have expanded P&F programs providing outreach, support, and mentoring to non-DRC-affiliated regional hospitals and universities. The majority of DRCs report that 70%–90% of their P&F awardees are successful in obtaining further research funding and staying within the field of diabetes/endocrinology/metabolic diseases. The requirement that a DRC allocate 25% of the awarded direct costs to the P&F program reflects NIDDK’s commitment to the success of the P&F program. P&F awardees from each DRC are highlighted yearly (found at https://diabetescenters.org/pilotfeasibility).

A related program that has grown out of the DRCs is the summer NIDDK Medical Student Research Program in Diabetes, which was established in 2009 and is organized through the Vanderbilt University Medical Center (https://www.vumc.org/niddk/welcome). This program provides medical students, early in their career, intensive mentored research at a DRC or a CDTR so that they have exposure to key clinical research concepts. Over the past 16 years, this program has trained close to 1,500 medical students from >140 medical schools, many of them non-research-intensive schools. DRCs routinely accept four to eight students into the summer program to participate in mentored research. At the end of the summer, students come together at Vanderbilt University where they present posters on their research and participate in a symposium that includes presentations by researchers on their career paths and scientific programs, and is an opportunity for networking.

Over the years, DRC programs have been involved in many key NIDDK-supported clinical trials, such as Type 1 Diabetes TrialNet (2), as well as key scientific discoveries such as the first islet transplantation rendering a human with type 1 diabetes insulin free (3) and the reporting on the genetic architecture of type 2 diabetes (4). In 2020, in response to the coronavirus disease 2019 (COVID-19) crisis, the DRC and CDTR directors established the Virtual Diabetes Research Seminar Series, including an opportunity for trainees to interact virtually with the seminar speaker (https://diabetes-virtual-seminar.org/).

Looking forward, the most important goal of the DRCs will be to facilitate research to provide new insights into diabetes, related diseases, and complications by increasing synergy and leveraging resources across center programs. Emphasis will also be placed on breaking down barriers and enhancing connections with the local community, as well as increasing the critical mass of investigators with a wide range of disciplinary backgrounds and experiences in the diabetes field through mentoring and outreach. In these efforts, NIDDK expects the DRCs to build on their decades of success and continue meeting the needs of the diabetes research community.

CDTRs

The mission of the CDTR program is to improve translation of research findings related to diabetes prevention and treatment, and to improve health care for all, by conducting research across the diabetes translation science spectrum (i.e., bedside to clinical practice and community settings, dissemination, and implementation research). These innovative centers are designed to bridge the gap between basic science discoveries and their practical applications in real-world settings. CDTRs focus on addressing key translational research challenges by using a multidisciplinary and multisectoral approach involving broad networks and team science that is inclusive of community partners.

After NIDDK combined the DERCs and DRTCs into the single DRC program (see DRCs), several observations informed NIDDK’s decision to create a dedicated program focused on late-stage translational research. For example, some applicant institutions were not equally active or strong in supporting all the required traditional biomedical cores and the translational prevention and control core. Therefore, NIDDK created the separate CDTR program in 2008 distinct from the DRCs with a clear aim of advancing diabetes research beyond clinical and basic studies by providing the infrastructure necessary to foster and expand diabetes translation research. In addition to expanding infrastructure, the primary objectives were to 1) accelerate innovation in diabetes translation and 2) grow scientific leadership in this field. The program scope also expanded to integrating novel and complementary research initiatives—such as pragmatic clinical trials in health care settings and natural experiment evaluation of large programs/policies aimed at improving care and management for diabetes and risk of complications—to establish NIDDK’s holistic strategy to address national priorities in diabetes translational research and population health.

In 2011, NIDDK funded eight CDTRs to create research resource cores focused on translating interventions and approaches that have clearly demonstrated efficacy for populations at risk and real-world health care and community settings. CDTR research could include effectiveness, dissemination, implementation, and cost-effectiveness research. Similarly, CDTR expertise covered a wide range of methodologies and approaches, many of which are not typically emphasized in other NIDDK programs (e.g., quasi-experimental designs, adaptive trials, complex designs and data systems analysis, health economic analysis, community-based and -engaged research), and measurement at various levels (e.g., individual, family, community, health care provider, system), always with a focus on bridging the gap between science and practice. NIDDK required that translational cores provide consultative services to researchers, an enrichment program to promote scientific education and exchanges among investigators, and a P&F program to provide seed funding, primarily for ESIs. Optional opportunities to support regional and national cores, and partnerships with teaching-intensive institutions with outreach to various patient communities, were also included. The initial CDTR structure set the stage for two subsequent renewals that have further broadened the scientific reach and impact of the program. Today, the seven currently funded CDTRs are organized as varied multidisciplinary and multisectoral partnerships across the country that include academic institutions, community health center networks, and human service agencies and other organizational partnerships with institutions (https://www.diabetes-translation.org/). The CDTRs have evolved to provide the envisioned infrastructure needed to advance research in diabetes prevention, treatment, and management, and improved health care for all through providing highly specialized technical expertise as well as core research resources to investigators across the country.

Since 2011, the CDTR program has continued to grow in scientific prominence and impact. CDTRs currently operate numerous local, national, and regional cores focused on complex scientific methodologies and approaches to promote translation of proven therapies to various populations and health care settings. The CDTRs have continued a track record of highly collaborative scientific activities across the translational research continuum. For example, CDTR cores have facilitated national guidance on clinical care in diabetes and a scientific review on social determinants of health and diabetes. Recently, CDTR cores informed policy evaluation on the impact of sugar-sweetened beverages and gestational diabetes mellitus prevention that has significant health implications (5,6). To move the field forward with expanded measures of impact, the CDTR program also contributed to a published framework (CDTR Research Impact Framework) as a resource for researchers, funders, and policymakers interested in assessing the full range of health and societal benefits of diabetes research investments (7).

The CDTRs’ collaborative efforts and unique infrastructure have also been leveraged to contribute to broader National Institutes of Health (NIH) efforts, such as grants to address urgent COVID-19 research, the Resource Center for Tribal Epidemiology Centers to provide training and technical assistance, and other types of support for Tribal Epidemiology Centers, and a national center for engagement to ensure that in diabetes-related research community perspectives and priorities are integrated into all stages of the research process, maximizing impact and action. To continue fostering opportunities for career development, NIDDK recently piloted a CDTR National Enrichment Program, which involved development of a virtual community of practice (COP) to foster scientific exchanges and education among ESIs, and a symposium with faculty mentors to promote ESIs’ scientific productivity. The COP remains active, with participants from 30 institutions, offering a cost-effective model to leverage existing centers’ programs to support and foster the growth of emerging leaders in biomedical research careers.

Looking to the future, the most important goal of the CDTRs will remain constant: to facilitate the rapid translation of efficacious interventions into real-world, health care, and community settings. The CDTR program will also continue nurturing multidisciplinary investigators and research teams who are equipped to tackle the biological and social complexities involved in diabetes translation and who can also build trust with community members to foster research innovation. Through these approaches, the CDTR program will remain a highly collaborative, innovative network to provide a unique platform for robust research in diabetes translation and scientific workforce development.

MMPC-Live

As outlined above in the section DRCs, NIDDK recognized an evolving need with the understanding that miniaturized physiological and metabolic technology was starting to be incorporated into DRC cores as genetic mouse models for diabetes were emerging, and the community felt that wider access to these methodologies was important for progress. Thus, to address this evolving direction, NIDDK established the MMPC program in 2001. The MMPC had as its mission to develop sophisticated, whole-body physiologic and metabolic phenotyping technology for use in mouse models of disease. Centers were charged with providing these tests to mouse researchers across the U.S. on a fee-for-service basis, to help make full use of the burgeoning number of genetic mouse models being developed for the study of obesity, diabetes, and its complications (8,9). The MMPC is therefore a resource to facilitate innovative preclinical research, particularly for those investigators who otherwise would have limited access to the state-of-the art metabolic and physiologic phenotyping demanded by high-quality publications and for successful grant applications. After two decades of service to the research community, the MMPC was reimagined in 2023 as the MMPC-Live (Research Resource Identifier RRID:SCR_008997) with a focus on its core strengths of providing rigorous tests in live animals and sharing that technology toward increasing the capacity across the country.

MMPC-Live is a consortium of four phenotyping centers served by a coordinating unit (CU). (See https://www.mmpc.org/shared/centers.aspx.) It is governed by a steering committee (SC) that consists of center and CU principal investigators, staff, and NIDDK staff. The CU and SC allow the centers to work together to compare and standardize practices, share protocols and technology, solve common problems, work on research projects, organize training initiatives, and provide opportunities to young scientists from underrepresented groups. Subcommittees provide input regarding animal husbandry, rigor and reproducibility, administrative issues, and the website. . The CU provides logistical and administrative support, conducts outreach (e.g., booth at major meetings, social media, brochures), and oversees financial management of the program. It maintains a rich website that houses a catalog of tests where clients can place orders, all test protocols, business tools, a database through which clients receive and can share their data, and tools for analysis of data (www.mmpc.org/). It also houses an “Education Portal” with webinars, software for analysis of energy expenditure data, and access to a variety of courses.

Each center consists of administrative and animal husbandry cores and one or more phenotyping cores. The primary activities are the sophisticated physiological and metabolic tests conducted on live mice, often accompanied by consultation with expert core staff to help design experiments. Tests are offered to clients inside and outside the home institution at similar cost and priority, and mice are shipped to the center institution. Resultant data are the sole property of the client, are banked in the MMPC-Live database, and can be released to the public in meeting the NIH data sharing requirements. MMPC-Live offers an extensive catalog of tests (https://mmpc.org/shared/orderTestSelection.aspx) with >150 options, focused primarily on glucose metabolism and homeostasis, lipid and protein metabolism, energy balance, body composition, eating and other behaviors, physical activity, cardiovascular health, pancreatic islet function, and the microbiome. Resources for experiments include extensive imaging technology and gnotobiotic facilities. Because many of the tests are relatively noninvasive, the same mouse can often be studied in several ways, and tissues can be harvested for further experiments.

MMPC-Live also sponsors training in its rigorous, standard methodologies. Two formal annual weeklong courses are held where hundreds of students have been trained in “Glucose Clamping the Conscious Mouse: a Laboratory Course,” now in its 21st year, and in “Isotope Tracers in Metabolic Research: Principles and Practice of Kinetic Analysis,” in its 16th year (https://mmpc.org/shared/courses.aspx). Webinars are available on the technology for use of isotope tracers and energy expenditure. Additional resources include a comprehensive laboratory manual for insulin clamps in the mouse (https://vmmpc.org/methods-standards/) as well as detailed protocols for other offered tests (https://mmpc.org/shared/protocols.aspx).

In addition, the new VIBRANT program of MMPC-Live is aimed at strengthening the U.S. biomedical research workforce (10). Specifically, given NIDDK’s strong focus on supporting the next generation of researchers, MMPC-Live provides resources aimed at young researchers to enable them to obtain data, training, community, and experiences that support efforts toward successful grant applications and careers. These resources include subsidized phenotyping services, travel awards, and expert review of grant applications prior to submission to a funding agency. They can also include consultation for experimental design and structured, hands-on training at one of the centers (https://mmpc.org/shared/vibrant.aspx).

In summary, MMPC-Live is an optimistic, outward-looking consortium focused on promoting high-quality technology for the physiologic and metabolic phenotyping of mouse models of obesity, diabetes, and their complications. Looking to the future, NIDDK envisions that MMPC-Live will continue its successful track record of developing and standardizing tests for living mice, which it provides to all mouse researchers in the U.S. on a fee-for-service basis. In addition, MMPC-Live will continue to provide training opportunities and resources for young scientists to promote a vibrant future U.S. biomedical research workforce.

CFRTCs

Cystic fibrosis (CF) is one of the most common, life-limiting genetic diseases and is estimated to affect ∼40,000 Americans (11). Although lung disease is the primary cause of death in CF, multiple organ systems have altered functions including the pancreas, liver, bone, and gastrointestinal, renal, and reproductive systems. To help promote CF research, NIDDK established the CFRTC in 1982 in response to congressional action. At that time, NIDDK initially funded four Cystic Fibrosis Core Centers (CFCC). Over the years, the name of the CF centers program has changed from the initial CFCC to the Specialized Centers for Cystic Fibrosis Research in the 1990s to the current CFRTC. In 2019, in response to an NIDDK Advisory Council recommendation and because CF is an area that is supported by other NIH components, NIDDK began requiring an emphasis on NIDDK mission-relevant research interests including in the major focus of the center, research base composition, research cores, and P&F studies. NIDDK mission-related CF research includes mechanisms underlying CF disease (excluding those associated with the specific development of lung disease), development of therapeutic approaches targeting or applicable to multiple organs, and elucidating pathophysiology and/or therapy directed at diabetes, nutritional, gastrointestinal, renal, hepatic, or gallbladder complications of CF. Overall, the major function of the CFRTCs has been fostering communication and collaboration between basic and clinical researchers and providing research core services, supporting a P&F program, and sponsoring an enrichment program to promote interdisciplinary interaction and educational updates.

Since initiation of the program, CFRTCs have been supported at multiple institutions and significantly evolved to reflect scientific/medical progress and the needs of the CF research communities they have served. The program currently supports seven centers (https://www.cysticfibrosiscenters.org/). As core services (e.g., peptide and oligonucleotide synthesizers) over time moved from scientific novelties to standard commercially available products, new CFRTC core services have replaced them. Some cores such as clinical, cellular, and animals have remained but have offered different services over time (https://www.cysticfibrosiscenters.org/services.html). Many of the CFRTC cores act as regional/national/international resources, and animal models and various types of cells are frequently shared.

CF research has significantly advanced, especially in the last 10 years, and the CFRTCs have been major contributors to these highly impactful advances. As a result of the significant advances over the last 40 years, the life expectancy of people with CF has increased from <20 years to now >60 years. All aspects of clinical care have improved, but the greatest single translational advance has been the development of highly effective modulator (HEM) therapy that, although targeted for pulmonary disease, also appears to have benefits in other organ systems affected by CF. The CFRTCs have contributed to this progress, including through supporting basic research to promote understanding of CF pathophysiology, creating new CF animal models, identifying potential therapeutics in preclinical models, and conducting clinical trials to evaluate the safety and efficacy of potential new therapeutics and nutritional approaches.

Given the progress to date, there is much to anticipate for the CFRTCs’ future. Despite the large clinical impact of the development of HEM therapy, research and further improvement of clinical care are still needed, and NIDDK expects that the CFRTCs will continue contributing to scientific progress. With longer life spans, diseases of the NIDDK mission are becoming increasingly more prevalent in people with CF, including increased incidence of CF-related diabetes (CFRD); ∼40% of adults with CF will develop diabetes (12). The full impact of HEM therapy on diabetes is still not completely clear, and optimal treatment including both the use and timing of diabetes drugs and nutritional approaches needs to be determined. A major question is what drugs beyond insulin, the current standard treatment, can be proposed to have efficacy in people with CFRD, including drugs indicated for type 2 diabetes. Other disease manifestations occurring more frequently with longer life include CF-associated liver disease–related kidney disease, both within NIDDK’s mission. Another important area of future CF research is various disease states related to CF heterozygote status—involving ∼10 million patients (13). Diseases of the NIDDK mission known to be affected by carrying a single mutated CF gene include diabetes, pancreatitis, cholelithiasis, nephrolithiasis, and constipation (10). A major question is whether HEM therapy would be indicated in these diseases when attributable to CF heterozygote status. Based on the above stated gaps in basic and clinical research, the CFTRDs will continue to play a critical role in addressing these and other research areas toward improving the health and quality of life of people with CF.

DEM Center Collaborations

Given the multiple pathogenic contributions to disease states of interest to NIDDK, collaboration between and among the DRCs, CDTRs, MMPCs, and CFRTCs, as well as other NIH-funded centers and programs (e.g., NIDDK’s Nutrition Obesity Research Centers and Digestive Diseases Research Core Centers), is strongly encouraged to leverage resources and facilitate highly collaborative, synergistic research. Collaborative pilot programs between DRCs and CDTRs, as well as with CFRTCs, take advantage of the collective expertise across the disciplines and provide unique opportunities for investigators to access additional resources at other centers and to form expanded collaborations with those in other centers to specifically advance scientific areas. For example, during the COVID-19 pandemic, investigators leveraged resources across the DRCs and CDTRs to address collaborative P&F projects aimed at elucidating the effect of the COVID-19 pandemic on diabetes at various levels (e.g., behavior, technology, and pathology). Recently, the Dartmouth CFRTC coordinated a P&F program that leverages diabetes expertise at DRCs and CDTRs to investigate CFRD; as of November 2024, seven proposals have been funded.

The DEM centers also foster partnerships with external organizations. For example, in 2023, the American Diabetes Association and NIDDK forged a partnership to expand the impact of the CDTR P&F program. As of November 2024, the American Diabetes Association has funded 23 pilot projects led by CDTR ESIs totaling $1.2 million to support high-risk, high-reward science and ESI career development and progression. Major collaborative efforts of the CFRTCs have continued with the Cystic Fibrosis Foundation including communications regarding funding efforts, cofunding of research projects, and participation in scientific workshops/meetings such as a CFRD workshop held in 2021.

Conclusion

As NIDDK marks our 75th anniversary, we celebrate the numerous accomplishments made by the DEM centers programs and the many people who have made possible these contributions to science, research, and health. Through support of these centers, NIDDK aims to foster novel collaborations that can lead to breakthrough findings on diabetes and other metabolic diseases that collectively affect millions of people in the U.S. and worldwide, ensure that research findings are translated to those who could benefit from them, and train the next generation of scientists to ensure a pipeline of future researchers studying DEM diseases. The DEM centers programs have been, and will continue to be, an integral component of NIDDK’s efforts to combat our mission diseases and improve health outcomes.