The diabetes epidemic in the United States (US) has evolved considerably over the last quarter century. Of note, the growth in prevalence and absolute numbers of people with diabetes has far exceeded statistical projections, growing proportions of those affected by diabetes are people of minority race/ethnicities and from lower socioeconomic backgrounds, and onset and first diagnosis appear to be younger than in decades past. Though the evidence base for diabetes prevention and management has grown ? and with that, some improvement in care and control of diabetes and associated co-morbidities ? major gaps persist: 1) The proportion of people with undiagnosed diabetes and prediabetes has not improved; 2) Engagement in prevention is exceedingly low; and 3) Young adults and disenfranchised populations with diabetes fare poorly in terms of control. And, while incidence rates of ?classical? diabetes complications like myocardial infarction, stroke, and amputations have dramatically declined in the last 20 years, again, these declines were less impressive for young adults, minorities, and low socioeconomic populations; and there have been increases in other diabetes complications like cognitive decline, depression, and heart failure. As such, it appears that younger people with diabetes will contend with classical complications earlier in life and older Americans with diabetes will contend with more years of physical and mental disability. This has profound implications for US health care in terms of the volume, complexity (i.e., multi-morbidity) of cases, and health system costs related to diabetes. To address these trends in the Southeastern US, where disparities in diabetes outcomes are particularly apparent, Emory University, Georgia Institute of Technology, and the Morehouse School of Medicine together propose to establish the Georgia Diabetes Translation Research Center (GDTRC). With its broad base of expertise; wealth of federal- and foundation-funded project platforms; access to communities, health systems, local and federal government; and readily-available tools and technologies; the GDTRC is poised to accelerate the conduct and use of diabetes translation research in the Southeast. The GDTRC offers Translation Research Cores (Design and Evaluation; Engagement and Behavior Change; and Disparities) designed to be responsive to the need to close remaining gaps in diabetes detection, prevention, and care, and to the changing profile of the US diabetes population. GDTRC will bring a spirit of innovation, collegiality, multidisciplinarity, inclusivity (e.g., considering disparities from traditional [race/ethnic] and new perspectives [e.g., disparities across the lifespan; disparate outcomes in people with depression or cognitive decline]), and continued learning towards promoting more and useful diabetes translation research. Further, the GDTRC's Regional Core, Enrichment Program, and Pilot and Feasibility Program will ?grow the pie? and generate awareness and demand, linkage to expert faculty, tools (e.g., open- access resource library) and opportunities (e.g., pilot and micro grants), and host online and in-person platforms to engage with GDTRC and its base of tremendous resources.
Despite recent improvements in the evidence base for diabetes prevention and care, significant gaps remain in translating these research findings into real life policy and practice; the overall burdens and costs continue to grow rapidly, with the Southeastern U.S. disproportionately affected. To address these gaps, we propose a Georgia Diabetes Translation Research Center (GDTRC) with the vision of promoting high-quality translation research and a culture of evidence based decision-making across academic, health system, community, and local government partners in Georgia, Florida, and Alabama. GDTRC will serve as a platform to increase investigator capacity, share expertise, and generate and disseminate knowledge to influence practice and policy to improve diabetes outcomes.
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