Tuesday, November 08, 2011

Who Pays For Diabetes Research?

It's hard to look at the shifting trends in topics about diabetes being studied without wondering what drives them. Who does diabetes research? Who pays for it? Who approves it? Why?

I can only begin to answer those questions. Some diabetes research is, clearly, paid for entirely by drug companies who are hoping that the results will help them sell their product or improve their odds of getting the product past the FDA or other regulatory bodies. Some small research is done by individual physicians who simply wish to share their observations or to study something that makes them curious, or by graduate students looking to write papers. Some research is funded and driven by well known diabetes names- the JDRF, the ADA, or the Iaccoca Foundation- that get money from donations from individuals, corporations, and sometimes governments. The ADA and JDRF often fund research done by drug companies (if you look up research by grant type on the ADA website, you'll notice that four of the grants are named after drug companies- Novo Nordisk, Takeda, and Merck).

A tremendous amount of diabetes research however is funded by tax monies. The United States Government has pledged $150 million per fiscal year for type 1 diabetes research for the past few and upcoming two years. The money is given to researchers and organizers after approval from the NIDDK. This money has gone to fund well known projects, such as trialnet (which two of my siblings participated in) as well as lesser known projects.
To compare these monies, the American Diabetes Association reported, for the fiscal year ending in 2009, income of $261 million, $141 million of which went to programs, which I think includes research.
The JDRF reported $198 million dollars income for a recent year, $156 million of which was spent on programs, which, again I think includes research. (Source: Charity Navigator)

A search on pubmed brings up 115 articles in which the authors acknowledge receipt of JDRF monies. Of these, 6 were published in the past year. Of these, one was a survey on quality of life in type 1 diabetics. One was about inflammation but otherwise was medical gobbledygook to me. One was a report of laboratory research that might translate into a prevention/treatment of diabetic kidney disease. One was a triggr follow up, which is a study of siblings and offspring of type 1 diabetics looking to find anything that might be responsible for triggering type 1 diabetes. In this case they are looking to see if a hypoallergenic formula might prevent diabetes. Another was a study on preventing kidney disease in diabetic rats. The last was a study looking to see how certain medications used to treat type 2 diabetes affect beta cells.
A search on pubmed brings up 149,792 articles in which the authors acknowledge connection to the NIDDK. Most do not have to do with diabetes. Out of the most recent three hundred articles, all published since this summer, twenty four were about diabetes, nine of the twenty four being clearly relevant to autoimmune type 1 diabetes, one being about HIV related diabetes, one being about the creation of the monogenic diabetes register, and thirteen stating that they were about type 2 diabetes or insulin resistance. A lot of research was done on transplantation.
Searching for ADA funded research is a little harder, because I keep getting articles done by people named Ada. Also, I get articles not funded by the ADA that cite "ADA guidelines"

Diabetes research done outside the United States has a lot in common with US research when it comes to drug industry funded research. However, other countries have other interesting slants and focuses. For instance, researches in various European countries have countrywide health databases to mine data from. Researchers in some places with standardized medicine do research looking to find that it's safe to reuse needles, for instance, or to promote cheaper ways of dealing with diabetes. Certain Asian and South American publications try to compare their populations' diabetes to that of Americans (the Japanese publish quite about about fulminant diabetes in the elderly).

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