Introduction and Specific Aims Diabetes mellitus is a significant health burden in the United States, affecting more than 20,000,000 people and cosfing more than $100 billion annually. The prevalence of Type 2 diabetes (T2DM) is growing rapidly;The CDC esfimates that up to 1/3 of Americans will have diabetes by the year 2050. The burden of T2DM is particularly great among ethnic minority populafions and those of lower socioeconomic status. The evidence base for the prevenfion and care of T2DM is one of the most well established of any chronic illness. For example, clinical trials have shown the efficacy of cardiometabolic therapies in prevenfing both mortality and morbidity in diabetes, and programs such as the Diabetes Prevention Program (DPP) have demonstrated that diabetes can be prevented in pafients at high risk for developing the disease. However, the overall quality of care for diabetes remains sub-optimal, and to date relafively litfie attention has been paid to programs for preventing diabetes. Programs which can effectively translate high-quality, evidence-based diabetes prevention and treatment into widespread practice are desperately needed. In response to this need, diabetes researchers at the Kaiser Permanente Northern California Division of Research, HealthPartners Research Foundafion, Harvard Pilgrim, and the University of California San Francisco (UCSF) propose to create a Center for Diabetes Translational Research (CDTR) that will actively foster and support translational research in diabetes within health care delivery systems affiliated with the HMO Research Network (HMORN) and the State of California. The proposed HMORN-UCSF CDTR will achieve its aims by developing a mulfi-disciplinary network of well-established investigators with a strong history of receiving both federal and foundation funding in diabetes translafional research. This CDTR will be structured around three Translational Research Cores in the areas of health care disparities, diabetes and obesity prevention, and the use of health information technology to improve diabetes care. The proposed CDTR invesfigators have significant experience in translational research in T2DM care and prevention in both adults and children, as well as in pregnant women with gestafional diabetes (GDM). These investigators have strong relationships with care delivery systems, ranging from large integrated delivery systems to networks of safety net providers that can serve as important partners for translating effective interventions into real-world clinical settings. The proposed CDTR will draw on a directly-affiliated clinical and insurance populafion of close to 5 million pafients, with approximately 300,000 pafients with diabetes of diverse racial/ethnic and socioeconomic backgrounds. The proposed HMORN-UCSF CDTR will leverage this expertise and partnership experience, as well as existing diabetes research collaborations among CDTR faculty, to foster and support new diabetes translational research opportunities both within and outside of the CDTR. This CDTR will serve as a regional resource to the State of California through its affiliation with the state's Diabetes Prevention and Control Program (California Diabetes Program) and support the State in conducfing disparifies surveillance, designing effecfive prevention and care programs for diabetes, and in creating evidence disseminafion and implementation strategies. In addifion, the CDTR will create a robust mentoring program that will encourage junior investigators in the creation of new translational research projects by providing methodological and content expertise;enrichment acfivities;and start-up funds for promising pilot studies
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