The Concept of Diabetes Translation

Addressing barriers to widespread adoption of new science into clinical care

The National Commission on Diabetes (NCD) performed a landmark review of diabetes in the U.S. in 1975 (1). Its four-volume 10-part report contained extensive testimony from all aspects of the diabetic community, including scientists, clinicians, patients, and their families. The NCD promoted a concept that was new to the diabetes field: the concept of translation. The NCD recognized that a significant weakness in the nation’s overall approach to diabetes was its failure to “translate” research findings into practice. Scientific knowledge was accumulating through the efforts of many basic and clinical investigators, but the application of this knowledge to all patients with diabetes who might benefit from it was spotty. The NCD initially charged Diabetes Research and Training Centers (DRTCs) with the responsibility of conducting translation with the following citation:Translate the advances in the field of diabetes research with least delay into improved care for the diabetic (sic) in the setting of model patient care demonstration units within the centers and through outreach programs in the regional community.Translation responsibilities were further extended to the Centers for Disease Control and Prevention in 1990 with the establishment of the Division of Diabetes Translation, which was created to implement translational programs that had been developed and shown to be effective. Development of such programs (i.e., translational research) remained the principal charge to the demonstration and education divisions of the DRTCs. Long-standing National Institutes of Health guidelines for DRTCs have stated (2):The central purpose of the Demonstration and Education (D&E) Division is to address barriers between what is thought to represent ideal diabetes care reflecting current scientific advances in the understanding of diabetes and what is routinely practiced.This commentary addresses the approach that the Michigan Diabetes Research and Training Center (MDRTC) has used to fulfill this charge (3).