PATHWAY TO A CURE: LAUNCHING THE NEXT GENERATION OF DIABETES RESEARCHERS

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t is time to begin a new era in diabetes research — one in which a community of trailblazing scientists think holistically, discover solutions in prevention and treatment, and ultimately cure this deadly epidemic. It is time for the American Diabetes Association’s Pathway to a Cure campaign: To launch the next generation of diabetes research and researchers and embark on a bolder course in funding these talented individuals.

Executive Team: Front center: Karen Talmadge, PhD Left side chair: Ginger Graham Right side chair: David Kendall, MD Back row left to right: Peter Kompaniez, Larry Hausner and Ralph Yates, DO

We are people

who dwell in the shadow of a quiet yet rapidly advancing disease, with two daughters and a wife who live with type 1 diabetes. Between us, we’ve spent decades fighting the disease as family members, fundraisers, and philanthropists. Although we’ve seen significant advances in diabetes research, this epidemic demands another approach…one that leads to a path of new insights and discoveries. Joining us, our fellow American Diabetes Association Research Foundation board members strongly and unanimously agree that a different direction must be taken. So we are embracing Pathway to a Cure. Pathway to a Cure is a campaign that proposes a transformational change: to fund a new generation of diabetes researchers — independent thinkers who are committed to a collaborative, interdisciplinary process that will generate fresh ideas and technologies — supplying them with enough funds to get started, build their labs and make their theories a reality. This disease demands our attention now more than ever. We face an even smaller pool of people choosing to enter the field of scientific research. In the fight for the best and brightest talent, attention is needed to financially support their interest and their development of new discoveries.

Pathway to a Cure will be different. Competitive, prestigious awards

will fund the process that encourages brilliant early-career researchers to energetically work together, to collaborate with and inspire one another. We believe promising, innovative directions and solutions will emerge, and we will build a new pathway filled with medical and technological advances. These awards will be larger than our standard grants, stimulating thoughtful exploration of the yet unsolved mysteries of diabetes. Five years ago no one predicted that we would have the newest oral medications, smaller needles, automated technologies that monitor glucose levels and administer insulin, and educational information that continuously improves our quality of life and longevity. American Diabetes Association-funded research has played a role in all of these critical advances. While we cannot forecast what will happen in the next five years, we are proud to contribute to a remarkable and exciting scientific endeavor through Pathway to a Cure. We invite you to join us on this journey.

Ralph Yates, DO

Peter Kompaniez

Karen Talmadge, PhD

Research Foundation Chair

Campaign Co-Chair

Campaign Co-Chair

EXECUTIVE SUMMARY

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hy diabetes research? To prevent a brain drain. Today, research dollars are rapidly decreasing and scarcer than ever. Early-career researchers with an interest in diabetes often find it difficult to compete with scientists who have established a track record.

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hy Type 1 diabetes? The management of type 1 diabetes is a constant and overwhelming burden to individuals with diabetes, families and society. Despite meaningful advances in care, individuals with diabetes face an enormous risk of serious complications, which diminish quality of life, and shorten life expectancy. And, we still await a cure.

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hy Type 2 diabetes? We face a pandemic. Over 25.8 million Americans have diabetes; another 79 million with prediabetes are at serious risk for developing the disease; and 1 in 3 children born after the year 2000 (1 in 2 minority children) will develop type 2 diabetes in his or her lifetime. Although the underlying cause for the disease differs between type 1 and type 2 diabetes, the same serious and life-threatening complications occur, at similar rates.

“Everyone today at the edge of science is in the dark. Success depends more on how the problems are defined, rather than on what solutions are reached. When Columbus went to Queen Isabella, he just said he thought he had a new way of going to India and wanted a couple of ships to get there. Similarly, the scientific investigator should say, ‘I have an idea. Could you fund me even if I don’t know if I can get there?’” Elias Zerhouni, NIH Director 2002 – 2008 NIH Medline Plus, Fall 2007

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he solution? Recruit a new generation of talented diabetes researchers. Identify these elite scientists and make a substantial financial commitment over a longer period of time to their diabetes-discovery career path.

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ho will help? Venture philanthropists with a spirit of adventure. Philanthropists who possess the passion to make great strides in advancing diabetes science will commit over a period of years to support their work.

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ollaborative scientific exchanges beyond their university will be required. Funded researchers will meet for idea-sharing and potential new research avenues through interactive virtual conferencing and an annual symposium. Continued funding will be based on progress and collaboration.

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hat can you do? Invest in tomorrow’s groundbreaking research and share our vision. The campaign seeks to raise $250,000,000 to significantly expand the number of elite diabetes scientists. Join the American Diabetes Association by making a leadership commitment today.

mission The future scientist you fund may hold the key to other diabetes successes.

Every path needs a pioneer, a destination and a mission: to Stop DiabetesŽ where it lives – in millions of homes all across the country.

to stop diabetes

THE CHALLENGE TO NEW SCIENTISTS: COMPETING FOR SCARCE RESEARCH DOLLARS Scientists often make breakthrough discoveries in the early years of their research as they emerge from the classroom, question current theories, focus on new approaches and develop novel connections that lead to seminal new ideas. Yet this is also a time when they face the greatest challenges in securing independent grants to pursue their own work while meeting the economic demands of home and family. Early-career researchers with an expressed interest in diabetes often find it difficult to enter the underfunded diabetes field, are increasingly drawn to better-funded diseases or seek employment outside of research. Many medical students, faced with alarming debt, choose to practice rather than enter the research arena because immediate funding is available. In today’s competitive environment, research dollars are scarce for new investigators. Lacking the resources and track records of established scientists, early-career researchers at the peak of their creativity find it hard to compete for limited research dollars. The average age at which scientists receive their first National Institute of Health (NIH) research grant has advanced to 42 years. Government funders increasingly look to private philanthropists to provide financial support for emerging scientists and their research.

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A diabetes research brain drain

What’s at stake? We must start making a substantial investment in these scientists or we risk losing a generation of diabetes researchers and postponing significant diabetes discoveries. As Dr. Aldo Rossini, Recipient of the 2003 Banting Medal for Scientific Achievement presented by the Association and Visiting Professor of Medicine, Joslin Diabetes Center, said,

“Finding a cure for an autoimmune disease, such as diabetes, must be viewed as a marathon. The bulk of research is carried out steadily over time. We need youthful researchers with fresh new perspectives to carry on the work started by forerunners in the field.” Meanwhile, the disease will continue on its runaway course, affecting millions more people, and requiring billions more dollars.

Despite obstacles, there are many reasons for hope

Researchers are pushing into new territory, spurred by advances in regenerative medicine, metabolic genomics, and in understanding the brain’s role in metabolism. Some experts suggest we may well be approaching diabetes’ final frontier. The challenges ahead of us have never offered such exciting opportunities for researchers and philanthropists to chart a course that could lead to breakthroughs in prevention and treatment, and finally to the eradication of this rampant, deadly disease. Many areas that have been found to impact diabetes, yet remain underfunded, include: The brain • The gut • Regeneration of beta cells • Fat metabolism • Repurposing drugs • Multi-hormonal therapies • Normal and abnormal physiological signals •

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To ultimately stop diabetes, the solution begins with recruiting a new generation of scientists and donors to the great adventure of diabetes research. The American Diabetes Association is outfitting just such an expedition to discover a pathway to a diabetes cure, and here’s how we will succeed.

LAUNCHING THE NEXT GENERATION OF DIABETES RESEARCHERS: INVENTIVE, INTERDISCIPLINARY, PROGRESSIVE AND TRAILBLAZING By expanding a research program that makes a significant investment in earlycareer researchers, the American Diabetes Association intends to convince a whole new generation that diabetes research is their new frontier. We will build upon our existing junior faculty awards by creating a new granting mechanism: Pathway Awards. We believe that by identifying this new talent pool, attracting them to the diabetes research arena, and making a substantial financial commitment

to them over a longer period of time, we will nurture the brilliant ideas that lead to swift scientific and clinical advances — and in the process create the next and greatest generation of diabetes researchers. Simply stated, we are funding a human pathway. These men and women, representing diverse disciplines, will possess the insight, the passion, the drive — and the means — to improve the lives of all people with diabetes, and one day eliminate the disease altogether.

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IDENTIFYING THE UP-AND-COMING PIONEERS OF DIABETES RESEARCH

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They are individuals with basic, clinical, and translational research ideas. Their education has inspired them toward a broad field of exploration. They have a map, but their pathway might show another road to solving the mysteries of diabetes. Pathway Awards will encourage these scientists to propose novel theories that may not even have been thought of during the writing of this case. These awards offer a blank whiteboard awaiting the next great idea, the next pathway.

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BUILDING A NATIONWIDE DIABETES RESEARCH COMMUNITY: INTERDISCIPLINARY BY DESIGN Basic scientists trained in metabolism, biochemistry, and/or molecular biology; endocrinologists trained in diabetes care;

The American Diabetes Association has a long, successful history of funding and developing scientists and innovative research without regard to location, creating a vibrant community of researchers. Our annual Scientific Sessions — the largest and most prestigious diabetes conference in the world — brings together more than 15,000 scientists and diabetes care professionals each year. We will use both our active scientific networks and our Pathway Mentor Advisory Group to identify the next generation of diabetes researchers.

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We will fund a new, nationwide research community composed of scientists from diverse backgrounds working on wideranging aspects of diabetes. This means supporting researchers and research areas like these:

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Clinical researchers and physician scientists trained in vascular disease, neurology, gastrointestinal conditions, and other body systems affected by diabetes complications. Neuroscientists who are looking at the link between diabetes and Alzheimer’s disease; •

Geneticists who are identifying markers for diabetes; and •

Biostatisticians who can design trials that process tens of millions of data points from a gene chip.

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With your partnership, Pathway to a Cure seeks to raise $250,000,000 to significantly expand the number of exceptional diabetes scientists by funding three year, or longer, Pathway Awards.

THE PATHWAY AWARDS The program is straightforward and targeted. It builds upon what the American Diabetes Association is known for: finding and jumpstarting diabetes research careers, with larger and longer grants. We have created two types of awards offering a higher level of funding which will:

1. allow an early-career scientist to build a new lab or join an existing one, hire additional staff and spend more time in the lab rather than searching for funding and

2. accelerate bench-to-bedside hypotheses. Our expectation is that these individuals, once established, will have a higher success rate for National Institutes of Health funding.

The American Diabetes Association maintains the infrastructure to manage Pathway Awards through its National Research Program. Our Research Policy Committee will establish the Pathway Mentor Advisory Group to identify and review proposals of the highest caliber. Members of the Mentor Advisory Group will be selected from the Associations’ Banting, Outstanding Scientific Achievement or Albert Renold award winners. Collaboration among researchers will be an essential part of the scoring and weighting of Pathway Awards, more so than our current grant application process. The Pathway Mentor Advisory Group will review, score, debate and prioritize the applications. Annual progress reports will be required, assessed for scientific progress and demonstrating clear evidence of crossfunctional collaboration. Annual incremental funding or additional funding will be provided with the approval of the Pathway Mentor Advisory Group for all awards where results are deemed meritorious.

Total investment and distribution of the Pathway Awards will be based upon donations toward the campaign. Ideally, we will announce Pathway Awards beginning as early as December 2011. Each lead gift investor will Non-Clinical/Fundamental Science Pathway Awards be given an annual campaign Minimum $250,000/year for 3 years Up to $750,000 over 3 years finance report outlining the Maximum $250-300,000/year for 4 or 5 years Up to $1.5M over 5 years donations received and allocated. We are looking for donor investors who, in collaboration Clinical and Translational Pathway Awards with scientists, will bring their Minimum $250,000/year for 4 years Up to $1M over 4 years own ideas and passion to helping Maximum $300-400,000/year over 4 to 5 years Up to $2M over 5 years define certain research project areas. As a diabetes community, it is our desire to work with investors, scientific staff, advisors and development staff to explore To quickly and effectively map the diabetes additional areas of interest. frontier, your help is needed to support a Through these combined efforts, greater number of early-career researchers. we will be able to accelerate new areas of diabetes exploration.

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CREATING INCENTIVES FOR A COLLABORATIVE EXCHANGE OF IDEAS

The vibrant, collaborative Pathway research community will ask the questions that have never been asked before and build resultsoriented solutions. How?

Pathway Symposium To further facilitate relationships and encourage the exchange of ideas, this new annual event will offer researchers a forum to present their findings, interact with one another, and hear presentations from renowned senior scientists on new developments in the diabetes field. Researchers will speak directly to their peers through oral presentations, abstract reviews, and after-hours discussions.

Interactive Virtual Conferencing To stimulate sharing across multiple scientific disciplines, while still enabling competition, making sure the best ideas are spread rapidly across the research network. Coinciding with their first progress report, biannual teleconferencing will be held.

Researchers + Philanthropists We will annually connect researchers and philanthropists during Scientific Sessions for the purpose of sharing insights and support.

The result?

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A generation of out-of-the-box thinkers who approach research in a collaborative, system-wide manner, determined to deliver the breakthroughs in basic and translational science, prevention, and treatment that will build a pathway to a cure.

FACING A PANDEMIC: THE STATE OF DIABETES AND DIABETES RESEARCH TODAY Diabetes is a debilitating disease that touches the lives of most Americans. It is the seventh leading cause of death. It lowers the average life expectancy, increases cardiovascular disease and is the leading cause of amputations, kidney disease and blindness. In addition, the direct and indirect economic impact of diabetes in the United States is over $200,000,000,000 annually. In type 1 diabetes, the insulin-producing cells of the pancreas have been destroyed. With the result that insulin, a hormone needed to convert sugar, starches and other food into the energy needed for daily life is not produced. It is estimated that five percent of people with diabetes have this form of the disease. Type 1 diabetes is usually diagnosed in children and young adults. With the discovery of insulin in 1921 and the introduction of insulin therapy in 1922, type 1 diabetes became a manageable disorder. Now more than ever, young children and adults with type 1 diabetes can learn to effectively manage their condition. But the burden of management remains enormous, while treatment goals are challenging to achieve every hour of every day. The consequence is that type 1 individuals face the short-term risks of disability and death through excess insulin, and the longterm risks of disability and death due to the challenges of maintaining glucose control. These long-term complications include heart attack, stroke, blindness, kidney failure, nerve damage, amputations and death. And, of course, we still await a cure. Thankfully, many universities and organizations have invested in type 1 diabetes research. Yet we know that

more must be done. Every time a child is diagnosed with type 1 brings home the fact that we have fallen short of truly impacting the field of type 1 research. Pathway to a Cure will be central in the effort to change that course. In type 2 diabetes, there are more subtle problems with the pancreas function and the inability of the body to properly utilize the insulin that it produces. Type 2 diabetes is the most common form of diabetes. Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk. Type 2 diabetes is more common in Asian Americans, African Americans, Latinos, Native Americans, Native Hawaiians and other Pacific Islanders, as well as the aged population. The U.S. Center for Disease Control and Prevention projects that one in three children born in 2000 (and one in two minority children) will develop type 2 diabetes in his or her lifetime if research and care do not move forward. More recent projections estimate that in the year 2050 one in three persons will be affected by diabetes. Due to the challenges of diagnosing and managing type 2 diabetes, these individuals face the same types of complications as individuals with type 1, impairing health, and shortening life. Pathway to a Cure will continue to build upon the strong foundation set forth by the Association’s National Research Program in type 2 diabetes. People with type 2 and their family members want answers now and Pathway to a Cure will be equally central in the effort to change that course.

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There have been breakthroughs in diabetes care and research, but more needs to be accomplished.

HELP US OUTFIT OUR ENTREPRENEURIAL EXPEDITION TO THE DIABETES FRONTIER: BECOME A VENTURE PHILANTHROPIST

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mentors

At the start of their careers, investigators need mentors, not only scientific mentors but also financial mentors. Venture philanthropists like you, who recognize their potential for exploration and discovery — potential that too often goes unrecognized in a scientific culture that typically rewards experience over new ideas.

We are looking for venture philanthropists with a spirit of adventure who possess the passion, the will, and the means to support the best new researchers and outfit their expeditions to the next diabetes frontier.

Who knows exactly what the investigator you support will find, what obstacles he or she will encounter or what false paths will have to be retraced. The journey takes vision. But it also takes fortitude: strength, courage, resilience, and determination. On all our parts. That’s what is required to find a new path to a destination we all envision: a world where no wife, daughter, son, friend, mother, husband, father or neighbor is touched by diabetes. Together, we can launch a bold, exciting entrepreneurial venture to pursue new paths in diabetes prevention, treatment, and cure.

VENTURE PHILANTHROPISTS: JOIN US IN FUNDING THE NEXT BANTINGS AND BESTS Frederick Banting was a 29-year-old assistant professor and Charles Best his 22-year-old medical student and colleague, when they co-discovered insulin. Join us in finding and supporting the next generation of Bantings and Bests — and ushering in an innovative new era in diabetes research. We will use your gift wisely by selecting the most promising early-career investigators, through our rigorous, proven peer-review process, and carefully monitoring their research progress.

Make a difference Early in their careers, investigators choose an area of research because the field is inviting, and they see an opportunity to make a difference. We all share that life goal: making a difference. As a venture philanthropist, you have the power to enable others to accomplish nothing less than helping to heal the world. That’s transformational change. That’s making a difference in the lives of all people living with diabetes, or at risk for developing the disease.

Set the course As a lead gift donor and venture philanthropist, you are an active stockholder in this scientific enterprise. You will be invited to attend, and encouraged to participate in, top-level scientific meetings, where investigators and American Diabetes Association staff scientists come together to communicate findings and stimulate new research avenues exploration.

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e are looking for philanthropists with a spirit of adventure who possess the passion, the will, and the means to support the best new researchers and outfit their expeditions to the next diabetes frontier. Pathway to a cure. Along this pathway we are taking our daughters, spouses, parents, grandparents and friends who live with diabetes daily. Will you join us on this Pathway to a Cure? Pathway to a Cure Executive Committee American Diabetes Association Research Foundation Ralph Yates, DO, Chair Ginger Graham, Vice-Chair Peter K. Kompaniez, Campaign Co-Chair Karen Talmadge, PhD, Campaign Co-Chair

American Diabetes Association Board of Directors John W. Griffin, Jr., Chair

American Diabetes Association Larry Hausner, Chief Executive Officer David M. Kendall, MD, Chief Scientific and Medical Officer M. Vaneeda Bennett, Executive Vice President, Development Elly Brtva, Managing Director, Individual Gifts

For more information on the American Diabetes Association Research Foundation and the innovative Pathway to a Cure campaign, please contact E. Brtva at ebrtva@diabetes.org or 1701 North Beauregard Street, Alexandria, VA 22311