Innovationf o r p r even t i on , hea l i ng and t he c u re

2013 annual report and overview

2Medical Advisory Board

Hwyda Arafat, Ph.D. ProfessorDepartment of Biomedical SciencesUniversity of New England

Donald W. Bowden, Ph.D. Professor of Biochemistry and Internal Medicine. Director, Center for Diabetes Research. Associate Director, Center for Human Genomics. Wake Forest University School of Medicine

Staley A. Brod, M.D. Professor of Neurology University of Texas, Houston

Tom L. Broderick, Ph.D. Professor of Physiology Division of Basic Sciences Midwestern University

Gregory Brower, D.V.M., Ph.D. Centenary Associate Professor Cell and Developmental Biology and Anatomy School of Medicine University of South Carolina

Ben Gerber, M.D., M.P.H. Associate Professor of Medicine Institute for Health Research and Policy University of Illinois at Chicago

Ira D. Goldfine, M.D. Professor of Medicine, Endocrinology/Metabolism University of California, San Francisco

Michael Haller, M.D. Assistant Professor, Pediatric Endocrinology University of Florida

Bethany Hall-Long, Ph.D., RNC Professor, Department of Nursing University of Delaware

E. Carolyn Johnson, Ph.D, FACSM Associate Professor and Non-Clinical Internship CoordinatorNutrition and Exercise Physiology, College of PharmacyWashington State University Spokane

William Jubiz, M.D. Director Centro de Endocrinology Metabolismo y Diabetes Cali, Columbia

Robert L. Judd, Ph.D. Chair, Boshell Diabetes and Metabolic Diseases Research Program Auburn University

Steven Koevary, Ph.D. Professor/Chairman Department of Biomedical Sciences and Disease New England College of Optometry

Suzanne Laychock, Ph.D. Professor of Pharmacology and Toxicology and Senior Associate Dean for Research and Biomedical Education The University of Buffalo School of Medicine and Biomedical Sciences

Lucy D. Mastrandea, MD, Ph.D. Assistant Professor Division of Pediatric Endocrinology Womens and Childrens Hospital of Buffalo

Marcia McInerney, Ph.D. Distinguished University Professor and Chair Medicinal and Biological Chemistry College of Pharmacy, University of Toledo

Joshua Miller, Ph.D. Associate Professor Department of Medical PathologyUC Davis Medical Center

Raghu G. Mirmira, M.D., Ph.D. Eli Lilly Chair in Pediatric Diabetes Associate Professor of Pediatrics, Medicine, and Physiology Indiana University School of Medicine

Charles Mobbs, Ph.D. Professor, Neuroscience, Endocrinology, and Geriatrics Mt. Sinai School of Medicine

Svetlana Mojsov, Ph.D. Research Associate Professor Rockefeller University

Merrily Poth, M.D. Professor, Retired Pediatric Endocrinology and Metabolism Uniformed Services of the Health Sciences

Steven Sansom, Ph.D. Associate Professor Dept. of Physiology and Biophysics University of Nebraska Medical Center

Thomas Schermerhorn, VMD, Dipl. ACVIM Associate Professor, Small Animal Internal Medicine College of Veterinary Medicine Kansas State University

Janet Silverstein, M.D. Professor of Pediatrics University of Florida College of Medicine

Ya-Xiong Tao, Ph.D. Associate Professor Department of Anatomy, Physiology, and Pharmacology College of Veterinary Medicine Auburn University

Roger Zoorob, MD, MPH Professor and Chair, Department of Family and Community Medicine

Vanderbilt University

2013 will be remembered for the beginning of our nations role in providing healthcare for millions of people who could not previously afford insurance or who were denied insurance because of pre-existing medical problems such as diabetes. Although politicians

may disagree on how to improve our health care system, I doubt that anyone believes that a person living in the U.S.

should have to go bankrupt or die because of a lack of insurance, or that insurance companies should be able to continue denying insurance for pre-existing conditions. Hopefully, in the future, the political squabbling will lessen and the Affordable Care Act will meet its goal of increasing preventive care that

could save billions of dollars by treating people, such as the 79 million Americans with pre-diabetes, before

their medical costs escalate.

This year will also be remembered for the government shutdown and budget sequester cuts. These cuts have made it more critical than ever for organizations such as Diabetes Action to help fund researchers who find it more difficult to obtain NIH funding. As one of the researchers we are funding wrote me, I have to say if federal funding doesnt improve drastically many of us, myself included, are seriously considering leaving researchIts just not sustainable even with the best research ideas.Keep doing the good work at DAREF, it is making a difference.

Despite these cuts in NIH funding, our ability to help some researchers obtain long-term government funding was successful. This year Dr. Nader Moniri at Mercer University let me know his NIH grant was approved with the highest possible score of 10, and said this wouldnt have been possible without the results collected through our DAREF support.

We are excited to know that many of the projects we are supporting can make a real difference in the lives of so many people with diabetes. At Massachusetts General Hospital, Dr. Denise Faustman is making progress on her goal to reverse type 1 diabetes with BCG vaccine, and is beginning the second phase of this study. At Mt. Sinai School of Medicine, Dr. Charles Mobbs has been able to show that a ketogenic diet with healthy fats such as organic butter, olive oil, coconut oil, and avocado oil can reverse the symptoms of both diabetic neuropathy and nephropathy.

We are so thankful to all our donors who make it possible to fund these groundbreaking studies, and a special thanks to our Diabetes Action Team fundraisers and our volunteer Medical Advisory Board and Board of Directors who are all so dedicated to improving the lives of those with diabetes.

Pat DeVoe, RN, BSN, President

Presidents Message

Hopefully the Affordable Care Act will meet its goal of increasing preventive care by treating millions of Americans with pre-diabetes before their medical costs escalate

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Diabetes Action Research and Education Foundation is committed to the prevention and treatment of diabetes and to the funding of innovative, promising research aimed at finding a cure for diabetes and diabetes related complications.

Alternative and complementary research Grants for nutritional research Promising research to find a cure for diabetes Innovative research to prevent and treat diabetes

International medical assistance American Indian diabetes prevention Childrens camp scholarship program Education and prevention programs

Our Mission

Our Focus

Assurance that your money is used wiselyWith a consistently low overhead and a small, dedicated staff, Diabetes Action strives to remain one of the most efficient charities. Diabetes Action is especially proud to have received the highest ratings from the following organizations:

CHARITY NAVIGATOR

Diabetes Action has received a rating of four out of a possible four stars which, according to Charity Navigator, differentiates Diabetes Action Research and Education from its peers and demonstrates to the public it is worthy of their trust.

see charitynavigator.org

BeTTeR BusINess BuReAu WIse GIVING AllIANCe

Diabetes Action has earned the right to display the Better Business Bureau Wise Giving Alliance charity seal of approval for meeting their comprehensive, in-depth evaluation of Diabetes Actions governance, finances, fund raising practices, solicitations, and informational materials.

see www.give.org

BesT IN AmeRICA

The Independent Charities Seal of Excellence is awarded to the members of Independent Charities of America and Local Independent Charities of America that have, upon rigorous independent review, been able to certify, document, and demonstrate on an annual basis that they meet the highest standards of public accountability, program effectiveness, and cost effectiveness.

see www.independentcharities.orgAmeRICAN INsTITuTes Of PHIlANTHROPY

Diabetes Action was one of the few diabetes organizations to receive an A rating in 2013. AIP conducts an in-depth, financial analysis of audited financial statements along with a charitys tax forms and other reports so donors will know how charitable dollars are really being spent.

see www.charitywatch.org

3 International medical assistance American Indian diabetes prevention Childrens camp scholarship program Education and prevention programs

Research ProgramCure for Type 1 Diabetes

GRANT TITle: A Program for the Cure of Type 1 Diabetes Using a Generic Drug: Phase II

ReseARCHeR: Denise L. Faustman, MD, PhD., Associate Professor

Harvard Medical School and Director Immunobiology Laboratory Massachusetts General Hospital

Charlestown, MA

PuRPOse: After successful comple-tion of the Phase I human study which showed that an inexpensive generic drug (BCG) could actually help the pancreas regain the ability to produce small amounts of insulin in long- term diabetics, Dr. Faustmans research project has now moved closer to participant enrollment for the Phase II clinical trial. The current focus of this study is to define subgroups among long-term diabetics to determine any differences in response to treat-ment according to length of illness. Currently Dr. Faustman is also looking at how rates of C-peptide decay and biological variation in C-peptide secretion might differ in individual par-ticipants, as well as in the subgroups of participants who had the same age of diabetes onset. In the meantime, follow-up studies of participants from the successful Phase I trial who received BCG vaccinations are being conducted to identify the drug dose and schedule that will put advanced Type 1 diabetes into remission.

GRANT TITle: Role of Bile Acids in Diabetes Remission after Bariatric Surgery

ReseARCHeR: Blandine Laferrere, MDPrincipal Investigator

St. Lukes-Roosevelt Hospital Center

New York, NY

PuRPOse: Bariatric surgery often results in remission of type 2 diabetes (T2DM). While weight loss is mainly responsible for the improved glucose metabolism, other mechanisms have been implicated after gastric surgery, as glucose levels improve rapidly, prior to any significant weight loss. In this proposal, Dr. Laferrere wishes to characterize new mechanisms explaining type 2 diabetes remission after gastric bypass surgery. Specifi-cally, the role of bile acids on the im-proved glucose and lipid metabolism and the improved gut peptide release after gastric bypass surgery will be tested. Circulating bile acids will be measured in samples from a cohort of obese patients with T2DM, before and after gastric bypass and gastric banding surgery. Understanding the effects of gastric bypass surgery on the action of bile acids will make it possible to further characterize the benefit of therapies that manipulate the enterohepatic cycle as treatments for T2DM.

GRANT TITle: Stearidonic Acid As A Potential Nutritional Therapy For Obesity And Type 2 Diabetes

ReseARCHeR: Kevin W. Huggins, PhD

Associate Professor Dept. of Nutrition

Auburn University, AL

PuRPOse: Increased consumption of n-3 polyunsaturated fatty acids (PUFA) have been shown to have health benefits associated with obesity and type 2 diabetes. The n-3 PUFA obtained from cold water fish and fish oils are the most effective source for these effects; however, due to concerns regarding the safety and sustainability with fish oils, there is need to identify alternative sources of n-3 PUFA having similar biological properties. Stearidonic acid (SDA) is a botanical n-3 PUFA that may have similar health benefits to fish oils. The purpose of this research project is to determine if SDA can be used as alternative to fish oil in the prevention of obesity and/or diabetes. The overall hypothesis of this research is that SDA will aid in prevention of adiposity, inflammation, and insulin resistance associated with obesity and diabetes in a mouse model. The results from this research project will serve to provide proof of principle for SDA as a therapeutic alternative for the treat-ment of obesity and type 2 diabetes.

Complementary / Nutrition Research

GRANT TITle: Novel Insights Into the Role of Vitamin D in Type 2 Diabetes: Implications for prevention and treatment

ReseARCHeR: Noelle Larson, MD

Assistant Professor of Pediatrics

Fellow in Pediatric Endocrinology

Tripler Army Medical Center, Hawaii

PuRPOse: Although it is known that vitamin D deficiency is associated with increased risk of developing insulin resistance and type 2 diabetes, the 2011 Institute of Medicine Report on reference intakes for calcium and vitamin D suggested that interventional data to support the routine use of vitamin D in the prevention and treatment of diabetes was lacking. This highlights the need for research to increase the understanding of the possible role of vitamin D in insulin action. This study is examining the effect of vitamin D and its metabolites on insulin sensitivity in adipose tissue to test whether vitamin D potentiates insulin action in fat tissue and to learn whether Vitamin D is metabolized in fat tissue. This testing will be performed on human adipose samples obtained from patients undergoing elective, planned surgical procedures as well as adipose tissue from pigs that will be used in the assay techniques for the human samples. Results from both visceral and subcutaneous fat samples will be compared from both obese and lean subjects.

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GRANT TITle: Vanadium and Cinnamon Derived Compounds as Therapies For Wound Healing in Diabetes

ReseARCHeR: Janice Zabolotny,

PhD., Instructor in Medicine

Beth Israel Deaconess Medical Center

Boston, MA

PuRPOse: Diabetic Foot Ulceration is a major complication of diabetes and the leading cause of non-traumatic lower extremity amputation in the U.S. Despite the clinical need for therapies for chronic diabetic wounds, there has been very little basic research aimed at identifying molecular mechanisms that can be augmented to overcome wound healing impairments in diabetes. Our data show that intracellular protein tyrosine phosphatases (PTPs), negative regulators of growth factor action, impede cutaneous wound healing. Blocking the action of PTP-1B accelerates healing rate and closure of cutaneous excisional wounds in diabetic mice. Vanadium and cinnamon derived compounds are well known potent inhibitors of PTP-1B, which also improve glucose tolerance in diabetic patients and promote healing of diverse experimental wounds in healthy animals. This study will determine whether these compounds are effective topical therapies that can restore cutaneous wound healing in preclinical models of chronic diabetic wounds.

GRANT TITle: Identifications of Novel Botanicals For the Prevention and Treatment of Type 2 Diabetes

ReseARCHeR: Dongmin Liu, PhD.

Associate Professor

VA. Polytechnic Institute & State University

Blacksburg, VA.

PuRPOse: The goal of this project is to identify low-cost bioactive compounds as complementary and alternative approaches to prevent and treat type 2 diabetes (T2D). T2D is a growing public health problem which is a result of chronic insulin resistance and loss of functional B-cells (the only source of insulin in our body). Thus, search for novel agents that simultaneously prevent insulin resis-tance and protect B-cell mass could be a novel and more effective strategy to prevent T2D. Dr. Liu discovered for the first time that baicalein, a flavonoid compound isolated from a Chinese medicinal herb, ameliorates diabetes due to protection of func-tional B-cell mass, while kaempferol, which is present in various natural plants and citrus fruits, might be an insulin sensitizer in the body. In this project Dr. Liu will explore whether the combination of treatment with baicalein and kaempferol is more effective in preventing T2D develop-ment by simultaneously preserving B-cell mass and improving insulin sensitivity in obese T2D mice.

GRANT TITle: Comparison of Fructose and Table Sugar as Sources of Caloric Excess in a Drosophila Model of Type 2 Diabetes

ReseARCHeR: Laura Musselman,

PhD. Research Instructor in Medicine

Washington Univ. School of Medicine

St. Louis, MO

PuRPOse: Many of us have heard of the dangers of high fructose corn syrup, and of caloric excess. Recently, science has shifted to place the blame for increased metabolic disease on dietary sugar instead of fat (see the NY Times 60 Minutes, HBO). Some scientists and dieticians suspect that fructose is worse for health than other sugars. Dr. Musselman has developed a model of insulin resistance that results from high sucrose feeding, where all dietary sugar consists of table sugar. High levels of table sugar induce Type 2 diabetes-like phenotypes in the fruit fly Drosophila. She has characterized the genomic, physiological, and biochemical responses to insulin resistance in high sucrose-fed Drosophila. What effects does fructose have? This study will compare fructose to sucrose and glucose to try to understand the differences, if any, between different sugar-containing diets.

GRANT TITle: Effect of Chromium Picolinate On Diabetic Vascular Complications

ReseARCHeR: Priya Raman, PhD.

Assistant Professor

Northeast Ohio Medical University

Rootstown, OH

PuRPOse: Diabetic patients are highly prone to vascular complications, substantially impacting national health care expenditures. Despite significant advances, no cost-effective alternative remedies are currently available for management of diabetic macrovascular disease. Trivalent chromium (Cr3+) picolinate (CrP), one of the largest-selling mineral supplements in the U.S., has a beneficial role in glycemic and cardiovascular health. Although previous studies underscore a protective role of Cr3+ in atherosclerosis, therapeutic value of CrP in diabetic vascular disease and mechanism(s) underlying its effect remain unknown. Dr. Ramans preliminary data demonstrates that CrP decreases expression of thrombospondin-1 (TSP- 1), a protein implicated in initiation of atherosclerosis. Dr. Raman proposes to test the central hypothesis that CrP alleviates diabetic atherosclerotic complications by reducing TSP-1 expression in the vessel walls and further uncover novel mechanisms underlying this effect. The proposed studies will significantly impact our current understanding of CrP, as a beneficial alternative and nutritional therapy for diabetes and its complications.

Complementary / Nutrition Research

5GRANT TITle: Neuroregulation of Diabetic Nephropathy

ReseARCHeR: Babu J. Padanilam, PhD.

Associate Professor

University of Nebraska Medical Center

Omaha, NE

PuRPOse: Diabetic nephropathy (DN), is one of the most ominous complications of diabetes, and is the leading cause of end-stage renal disease. Recent reports indicate that sympathetic hyperactivity is common in chronic kidney disease (CKD) and is shown to contribute to glomerular nephritis and induce proteinuria both through and beyond its effect on blood pressure. Several recent reports indicate that increased sympathetic activation is an early event in the pathophysiology of CKD, rather than a consequence, and its sustained activity has adverse clinical consequences. The objective of this proposal is to determine if renal denervation prevents the pathophysiology of diabetic nephropathy and define the mechanisms by which renal nerve activation instigates inflammation and fibrogenesis in T2D kidneys. These proposed studies on the neural regulation of renal fibrogenesis are paradigm-shifting as it has never been reported and will have the potential to transform the way we investigate fibroproliferative diseases. Elucidation of neural regulation in DN may provide a conceptual framework for identifying novel therapeutic targets.

GRANT TITle: Role of VGF in Beta Cell Function, Insulin Secretion, and Glucose Homeostasis

ReseARCHeR: Stephen R.J. Salton, M.D., PhD

Professor of Neuroscience and Geriatrics

Mt. Sinai School of Medicine

New York, NY

PuRPOse: Germline ablation of the Vgf gene results in a lean and hypermetabolic knockout mouse that is resistant to diet-, lesion- and genetically-induced obesity and diabetes. Modulation of VGF levels or VGF signaling may therefore represent an alternative means to regulate circulating glucose levels and insulin sensitivity. Recent studies from the Newgard lab have demonstrated that the VGF-derived peptide TLQP21 enhances insulin secretion, improves glucose homeostasis, and preserves beta cell mass, through a mechanism that is similar to but distinct from GLP-1R agonists. Utilizing previous Dia-betes Action funding, Dr. Salton has generated VGF mouse models that (1) express full length human VGF(1-615), (2)express truncated VGF(1-524) that lacks the TLQP21 peptide, or (3)have loxp recombination sites flanking the mouse VGF coding sequence. To further investigate mechanisms by which VGF regulates glucose balance, Dr. Salton will generate and characterize beta-cell conditional VGF knockout mice, and lines expressing full length and truncated human VGF.

Gene Research

GRANT TITle: Myeloid-Derived Suppressor Cells for Tolerance to Islet Transplants

ReseARCHeR: P.I., Luca Inverardi, MD, PhD, Research Professor of Medicine, Microbiology and Immunology

Co-P.I., Paola Serafini, PhD., Asst. Re-search Professor, Dept. of Microbiology and Immunology

Alessia Zoso, PhD., Diabetes Research Institute Foundation

Hollywood, Florida

PuRPOse: Survival of transplanted insulin producing islet cells requires life-long immunosuppressive drugs, which cause a number of undesirable side effects including damage to the islets themselves. They also shut down the entire immune system, leaving the patient susceptible to viruses and infections. The critical need that this project addresses is to obtain a means of inducing transplant tolerance- thus changing islet transplantation from a procedure with serious side effects to a safe one. Myeloid-Derived Suppressor Cells (MDSCs) naturally accumulate in certain areas of the body. Cancer researchers are familiar with the negative effect of MDSCs on malig-nant tumors but this study attempts to put MDSCs to work in our favor by using them to interfere with the immune systems ability to attack the insulin-producing islet cells that we transplant to reverse diabetes.

Beta Cell ResearchKidney Research

GRANT TITle: Lifestyle Intervention For Diabetes

ReseARCHeR: Adam Bernstein, MD

Director of Research, Wellness Institute

Cleveland Clinic

Cleveland, Ohio

PuRPOse: Although targeting low- income women for health care screening and interventions has been a priority of the US Centers for Disease Control and Prevention for the past 15 years, little is known on how to adapt and deliver evidence-based lifestyle interventions for chronic disease to fit the needs of low-income, urban populations. Dr. Bernstein proposes a pilot study of a lifestyle modification program for overweight or obese African-American women with diabetes. As recommended by the ADA, the program emphasizes diet, exercise, and cognitive behavioral therapy. However, based on focus groups performed with African- American women in the low-income community of East Cleveland, Dr. Bernstin proposes the incorporation of mind-body practices that address more inner and spiritual aspects of mental health to allow participants to maintain the recommended lifestyle changes in a sustainable manner. If successful, the proposed research has the potential to significantly affect the health and quality of life of a large percentage of the population.

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GRANT TITle: Multidrug Resistance Protein-1 as an Essential Regulator of Vascular Inflammation and Diabetic Restenosis

ReseARCHeR: Manikandan Panchatcharam, PhD.

Assistant Professor

Department of Cellular Biology and Anatomy

LSU Health Sciences Center, Shreveport, LA

PuRPOse: Approximately 180 million people worldwide have diabetes and this figure is expected to grow to 366 million in 2025, according to the Centers for Disease Control and Prevention. Diabetes is a chronic disease in which a person has high blood sugar, which leads to the clas-sical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (Increased hunger). Left unmanaged, diabetes can bring on complications such as heart disease, problematic vision, kidney disease, nerve damage and loss of limbs. Drugs used to treat uptake of sugar in cells are not effective due to the action of multidrug resistance proteins, which are elevated during diabetic condition. The major problem addressed here is to study the role of multidrug resistance protein-1 in normal and diabetic condition, which would lead to a new window for the therapeutic treatment by regulating multidrug resistance protein-1 levels in the diabetic patients.

GRANT TITle: Coaching for Control: A Pilot Study of a Medical Student Intervention to Promote Diabetes Self-Care in High Risk Settings

ReseARCHeR: Mercedes Carnethon, PhD, Assoc. Professor

Associate Chair for Mentoring & Faculty Development

Northwestern University

Chicago, IL

PuRPOse: Diabetes poses a substan-tial burden to racial/ethnic minorities and in populations with limited access to healthcare. However, there is a shortage of healthcare providers available to help patients adopt the lifestyle changes required for diabetes control. The goal of this study is to evaluate the feasibility and effective-ness of a diabetes self-care interven-tion delivered by medical students to patients with poorly controlled diabetes. Training medical students to use proven communication techniques to help patients identify and overcome barriers to adopting lifestyle changes in diabetes is a novel but plausible strategy. Dr. Carnethon anticipates that findings from this pilot study will be used to develop a larger study to definitively test the programs effectiveness. A long-term benefit of this program is that future healthcare providers are practicing the skills needed to promote positive lifestyle changes and provide care for chronic conditions in diverse communities.

GRANT TITle: The Diabetes Center Summit: Operations, Management and Quality Imperatives

ReseARCHeR: Les Jebson, M.H.A.

Administrator, The Diabetes Center of Excellence

Univ. of Florida Academic Health System

Gainesville, FL

PuRPOse: In 2009, approximately 1,406,000 adults in the state of Florida had been diagnosed with diabetes. In 2009 approximately 87% of all adults in Florida were overweight or obese and 41.6% were physically inactive. This summit will focus on how to better manage the diabetes population in Florida, with the intent being that its success and design can be used for other state level or regional diabetes educational events in other geographic locations through-out the country. This conference is unique by being designed for Admin-istrators, Managers, and Research Coordinators of Diabetes facilities throughout the region and will be free of charge for attendees without any commercial/industry funding. In order to better manage the exploding population of patients with diabetes, it is critical that innovative ways of in-creasing coordination among diabetes care providers be developed in this Symposium.

GRANT TITle: The Development of an Evidence-Based Smartphone Application for Diabetes Self-Management

ReseARCHeR: Ronald Tamler, MD

Director, The Mount Sinai Diabetes Center

Mt. Sinai School of Medicine

New York, NY

PuRPOse: The goal of this project is to build a Smartphone application (app) based on clinical evidence and established behavioral science that makes it easier for people with diabetes to self-manage this chronic disease. The study will use focus groups, the development team and a 3 month pilot study to develop the efficacy and usability of the Smart-phone app. Dr. Tamler hopes to make this chronic disease management tool widely available on both the website and app stores so that thousands of people with diabetes will be able to download the app and self -manage their disease by monitoring their nutritional habits, life style choices and medication adherence, among other features which will empower patients with diabetes.

education Vascular Research

7GRANT TITle: Chromatin Protein Complexes and Regulation of Cardiac Hypertrophy

ReseARCHeR: Susan Marsh, PhD.,

Assistant Professor

Washington State University

Spokane, WA

PuRPOse: The heart undergoes changes in shape and strength (hypertrophy) in response to hyperten-sion, diabetes, and exercise training, although the remodeling caused by these interventions results in differ-ences in the shape, size, and function of the hearts muscle cells. Hyperten-sion causes hypertrophy through changes in protein interactions that regulate the winding and unwinding of DNA, which, in turn, affects which genes are copied; this ultimately determines the changes that occur in the muscle cells of the heart. Our preliminary experiments indicate that these events also occur in exercise-trained and diabetic hearts which is somewhat unexpected as exercise-trained hearts are stronger and more efficient than hypertensive and/or diabetic hearts. The studies in the pro-posal will investigate whether these changes are essential for remodeling of the hearts muscle cells.

GRANT TITle: Exploiting A Novel ATP-Regulated Molecular Switch To Selectively Boost Akt2, But Not Akt1 Signaling In Diabetic Cardiomyopathy

ReseARCHeR: Tung Chan, PhD.,

Assistant Professor of Medicine

Thomas Jefferson University

Philadelphia, PA.

PuRPOse: Patients suffering from dia-betes, in particular African-Americans, are at increased risk of developing heart disease, even without high blood pressure. Heart disease remains the leading cause of death in the US and despite therapeutic improvements, outcomes in chronic heart failure remain poor with a 5-year survival only around 50%. While moderately effective, current treatment options for diabetic heart failure are limited. In this application, Dr. Chan will help to develop a novel effective treatment for this condition by restoring the function of a critical intracellular effector of insulin action (Akt2) in cardiomyocytes. A second focus of this study is the development of new assays that can be used in living human heart tissues or fat tissues to study differences in response from heart failure and diabetes patients.

GRANT TITle: Reversal of Diabetic Neuropathy by a Ketogenic Diet

ReseARCHeR: Charles Mobbs, PhD.

Professor, Neuroscience, Endocrinology, and Geriatrics

Mt. Sinai School of Medicine

New York, NY

PuRPOse: Dr. Mobbs recently reported that a ketogenic diet reverses diabetic nephropathy in mouse models of both Type 1 and Type 2 diabetes and that ketones are highly protective of neurons in an in vitro model of diabetic neuropathy. Furthermore, the ketogenic diet is clinically safe and effective in treating epilepsy in humans and diabetic neuropathy appears to be at least partially reversible under optimum conditions. Thus Dr. Mobbs hypoth-esizes that the ketogenic diet will also at least partially reverse diabetic neuropathy by reducing glucose metabolism more effectively than simply reducing blood glucose, as analyses of bistable metabolic states suggest that even temporary but substantial reduction in glucose metabolism may reset the meta-bolic state and produce protective effects that persist after resumption of a normal diet. Thus, the goal of this study is to assess if the ketogenic diet will reverse diabetic neuropathy in a mouse model of type 2 diabetes and if these protective effects persist even after a return to a normal diet.

GRANT TITle: The Mechanism Approach of the Therapy For Diabetic Neuropathic Pain

ReseARCHeR: Yan Ping Zhang, PhD.,

Assistant Scientist

University of Miami

Miami, Florida

PuRPOse: Diabetic Neuropathy is a nerve disorder caused by high blood sugar. About 60-70% of people with diabetes have mild to severe forms of diabetic neuropathy. Painful diabetic neuropathy (PDN) can have devastat-ing effects on a patients health and overall quality of life. High blood sugar causes metabolic dysfunction trigger-ing nerve damage in diabetes. Cells and tissues damaged by high blood sugar in turn stimulate the natural immune defense system to produce free radicals (highly reactive oxygen molecules that damage tissues) and toll-like receptor 4 (TLR4) is critically important in regulating these respons-es. In diabetes, Dr. Zhang hypothesiz-es that TLR4 activation in the spinal cord plays a key role in perpetuating neuronal injury and the symptoms of PDN. The proposed research will apply TLR4 antagonist to inhibit potentially harmful natural immune responses, and protect from PDN.

Heart Disease Neuropathy

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Beneficial effects of Cinnamon on Diabetes and Alzheimers Disease

Dr. Richard Anderson described his many years of research, including studies that were supported by Diabetes Action, which showed the health benefits of a water-soluble extract of cinnamon. This extract has not only been shown to improve insulin resistance in women with polycystic ovary syndrome, improve blood glucose, blood pressure and cholesterol levels in people with metabolic syndrome, but was also shown to prevent the growth of blood vessels necessary for the spread of cancer. In addition, Dr. Anderson demonstrated how cinnamon was able to break up the Alzheimers filaments from a human brain.

short Chain fatty Acids in Coconut Oil and Ketogenic Diets food for Thought

Dr. Beverly Teter provided information on the benefits of a ketogenic diet, which is high in good fats such as organic butter, whole fat dairy (which an NIH funded Harvard study had previously shown to lessen the risk of type 2 diabetes by 60%), coconut, and avocado oil. Dr. Teter stressed the need for fat to nourish the brain and discussed her contacts with Dr. Mary Newport, who treated her husbands Alzheimers with coconut oil. Thus, it may be time to rethink the

popular advice to avoid all saturated fats.

The Importance of Vitamin D in Diabetes: The state of the science and the Practice

Dr. Ryan Bradley discussed the results of his own research study that tested three different forms of Vitamin D, and also described conflicting results of numerous studies on the benefits of vitamin D for diabetes. Numerous studies have shown that higher levels of vitamin D are associated with a decreased risk of developing type 2 diabetes. For type 1 diabetes, although some studies did not show an improvement in C Peptide levels after taking supplemental D, other studies that used higher doses of vitamin D did show significant improvement, so the results may be dose dependent. The most illuminating statistic was that children with low vitamin D levels have a 200% increased risk of developing type 1.

Education Program

Diabetes university

Diabetes Actions annual Diabetes University provides updated information on diabetes treatment and focuses on alternative therapies which are an area of interest to more and more people seeking non-traditional ways to improve their health. Our 2013 program featured the following presentations:

Please visit www.diabetesaction.org to view past and current Diabetes University programs.

Dr. Teter explained why the brain needs fat and how coconut oil is a healthy saturated fat.

9American Indian Diabetes Prevention Program

Our ongoing support of the American Indian Diabetes Prevention Program is helping to fight the epidemic of type 2 diabetes on the Cheyenne River Reservation in South Dakota by promoting a return to traditional foods, exercise programs, and public health education.

In addition to the efforts of a diabetes educator who has provided nutrition programs for both children and their families, our funding in 2013 supported the first ever Teen Internship program focused on youth wellness and the two acre Winyan Toka Win (Leading Lady) Garden.

During this special summer program, the teens not only learned the basics of gardening, processing, and canning, but they also received CPR and food handler certification, attended special training sessions in financial literacy, suicide prevention, drug and alcohol prevention, and basic nutrition and diabetes prevention.

One of the biggest hurdles to overcome on most reservations is the reliance on the Federal Food Program that provides unhealthy foods such as processed meats, which have been shown to contribute to diabetes. Replacing packaged food with food harvested from the land will help these teens reduce their risk of diabetes.

This highly successful program helped the teens form new healthy habits while encouraging their family and friends to live a more healthy life.

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Diabetes Action TeamCongratulations to the 216 Diabetes Action Team members for raising over $168,000 for diabetes research in 2013! Each team member had their own inspiring story and reason for joining the team, but everyone came together with the common goal of raising money to fund vital research. We are so proud of all our team members for both their athletic accomplishments and their amazing commitment to the cause of conquering diabetes.

BANK OF AMERICA CHICAGO MARATHON

Cristine Ale

Nicholas Allen

Jeanette Anderson

Chris Anderson

Venkat Arcot

Erika Barragan

Erico Barrera

Ryan Bauer

Kevin Beyer

Tracey Bustin

Brock Buttrick

Robert Caton

Joshua Crowley

Suzanne Dailey

Benjamin Deines

Arra Derderian

Tom Dow

Mel Eason

Beiker Espinoza

James Fisher

Amanda Funk

Celeste Galizia

Tim Geraghty

Kevin Greene

John Guanzon

Shelli Hancock

Jessica Harpenau

Lindsay Hattendorf

Jason Heckman

Kaylyn Howley

Alvaro Hoyos

Jonathan James

Venkata Jayanti

David Johnson

Jill Jones

Julie Karwowicz

Robert Kern

Monica Korell

John Kovas

Jennifer Laun

Kellie Leinung

Bobbi Long

Vincent Luna

Jody Malone

Jeffery Martin

Robert Meyer

Maren Mineo

Rica Misra

Troy Moffett

Santa Montiel

Antonio Montiel Jr.

Eddie Mora

Bryan Morin

Colin Morlock

Patrick Morrison

Christine Morrison

David Mussatt

Kim Nelson

Paul Nette

Patrick Newcomer

Han Ngo

Vanatus Nwaigwe

Michael Oakes

Vipul Patel

Athena Perez

Andrew Perez

David Phillips

Mindy Poleski

Matt Polifko

Matt Pook

Margaret Portelli

Arianne Rodriguez

Renee Rossi

Anna Ruspa

Nikki Rybarczyk

Lea Sawicki

Kody Scherbarth

Kimberly Schmitt

Ashley Schock

Nakima Sepulveda

Summer Smith

Jonathan Starke

Shannon Sullivan

Barb Tatham

Joseph Tess

Billi Tierney

Erik Toman

Rakesh Reddy Veligati

Lawton Warzala

Jesse Wickizer

Bruce Willcox

Valerie Yaw

Jeffrey Zonderman

MARINE CORPS MARATHON

Daniel Adame

Roberto Anguizola

Nicholas Beeson

Jerry Bennett

Neil Boulton

Lynn Bowen

Kevin Boyce

Marshall Braun

Monique Canale

Omar Canty

Jasper Caparas

David Cleveland

Laura Cohen

Brian Coughlan

Cindy Coxie

Neelima Dandamudi

Angela Diorio

Deborah Dorber

Courtney Duckworth

Tami Estep

Seth Ewing

Ken Fagut

Barb Flahive

Matthew Garcia

Luis Garcia

Dan Gay

Jerome Geisler

John Hesser

Nancy Highburger

Suzanne House

Jimmy Huang

Zach Hutcheson

Christine Hutcheson

Jan Irvine

Gregory Jones

Jeremy Karbowski

Vandana Kumari

Elizabeth Lazdins

Stuart Levinsky

Gisele Loto-Rojas

Lynn Mattucci

Carrie McKinney

Benjamin McNaughton

Dawn McNaughton

Dawn Meyers

Kasey Mitchell

Dena Mizrahi

John Morrison

Mallory Myers

Dawn Nelson

Virginia Parker

Bonilyn Parker

Janet Petersen

Brian Phelps

Christopher Piskun

Bhaviksha Ranchod

Angela Reineck

Jalil Rodriguez Perez

Augusto Rojas Jr.

Bob Romero

Claudia Saavedra

Claudia Santos

Jenica Scott

Kelly Snavely

Michael Spencer

John Spillane

Victoria Spratt

Matthew Stiegemeyer

Marilyn Swann

Xochitl VanderPlas

Melissa Voight

Karen Walden

Lisa Whalen

Thomas Willauer

Christopher Willauer

Ever Zavala

NYC HALF MARATHON

Kaja Gjessing-Newman

Damian Romero

Deana Welsch

ROCK N ROLL USA

DMeryl Grenadier

Danielle Gurkin

Peggy Ledell

Tanya Pardo

Chris Roberts

VIRTUAL DIABETES ACTION TEAM

Dana Canzano

Katherine Krause

Ronald Lawrence

2013 Team members

sPeCIAl THANKs TO OuR TOP fuNDRAIseRs

Jerry Bennett $5,768

Augusto Rojas Jr. $4,034

stuart levinsky $2,808

Kaja Gjessing- Newman $2,482

shannon sullivan $2,166

Janet Petersen $2,126

Danielle Gurkin $1,695

Gregory Jones $1,627

lynn Bowen $1,575

Kellie leinung $1,532

11

In 2013 Diabetes Action provided over 1.6 million dollars of medical supplies to aid the victims of natural disasters in both Haiti and the Philippines.

In Haiti, life is still a struggle for millions of people trying to recover from the devastating earthquake of 2010 and the following cholera epidemic that has strained the resources of all medical facilities. Our medical supplies were distributed to hospitals at St. Marc, Cabara, and Arachaia plus various medical clinics in outlying villages such as LaDigue.

After a massive typhoon destroyed many rural health clinics in the Philippines, Diabetes Action sent additional medical supplies to help provide medical care to the more than 14 million people affected by this devastating typhoon. Medical Clinics run by Children International in Quezon City, Manila, and Legaspi City were grateful to receive this much-needed medical assistance.

Relief Efforts

2013 Childrens summer Camps

One of our most gratifying programs is the annual support of summer camps for children with diabetes. At these camps, children with diabetes have a place to feel normal with other kids living with diabetes in a safe environment. Camp combines fun and adventure along with education on how to manage a healthy life with diabetes. We love to read the stories from children who write each year to thank us for making it possible to have this special experience, but the letters from parents are also heartwarming. A mom of a camper recently wrote, Danielle has not stopped talking about camp and the friends she made who are just like her! She was so proud of herself for coming home with the ability to give herself some of her injectionsa big step forward for her.

Summer Camps

Camp Seale Harris, AL Camp Kushtaka, AK Camp Aldersgate, AR U of Arizona Foundation, AZ CampConrad Chinook, CA Camp Sweet Pea, CO Rainbow Club, CT Camp Possibilities, DE College of Health and Nursing Sciences, DE Florida Diabetes Camp, FL Camp Kudzu, GA YMCA Honalulu, HI Camp Hodia, ID

Camp Granada, IL Triangle D Camp for Children with Diabetes, IL Diabetes Youth Foundation, IN Hertko

Hollow Childrens Diabetes Camp, IA Camp Discovery, KS Camp Hendon, KY Camp Victory, LA Clara

Barton Camp, MA Lions Camp Merrick, MD Carys Diabetes Kids, ME Camp Midicha, MI Camp Needlepoint,

MN Camp Daypoint, MN Camp Hickory Hill, MO Youth Retreat, MT Twin Lakes Diabetes Camp, MS

Camp Carolina Trails, NC Camp Sioux, ND Nevada Diabetes Association, NV Floyd Rodgers Camp, NE Camp

Carefree, NH Zebra Crossing, NH Camp Nejeda, NJ Kamp 4 Kids, NM Circle of Life Camp, NY Camp

HoMita Koda, OH Camp Korelitz, OH Camp Endres, OK Chris Dudley Basketball Camp, OR Camp Setebaid,

PA CEBNAD Diabetes Camp, PR Camp Surefire, RI Camp Adam Fisher, SC Camp Gilbert, SD Tennessee

Camp for Diabetic Children, TN Texas Lions Camp, TX Utada Camp, UT AYUDA, VA Camp Holiday Trails, VA Camp Sealth, WA Wisconsin Lions Camp, WI Camp Kno-Koma, WV Camp Hope, WY

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Financials/Misc.

BoardBOARD CHAIR: Patricia A Faulkner

TReAsuReR/seCReTARY: Anne Lafferty

DIReCTORs:

Rachel GoldfarbJoan KaiserDonald T. Krizek, Ph.D.Jan Taylor

Principal staff members:PResIDeNT: Pat DeVoe, RN, BSN

exeCuTIVe DIReCTOR: Dorothy Harriot, LCSW-C

Diabetes Action Research and education foundation Inc.

BAlANCe sHeeT

December 31, 2013

AsseTs

Current Assets Cash - Checking $40,315

Cash Money Market $158,749

TOTAL ASSETS $199,064

PuBlIC suPPORT AND ReVeNue

Contributions $586,864

In-Kind Contributions $1,682,512

Legacies, Bequests $24,453

Interest Income $94 Other Income $335

Special Events $159,610

TOTAL PUBLIC SUPPORT AND REVENUE $2,453,868

exPeNses

Public Education $316,400

Biomedical Research $257,575

Summer Camps $21,450

In-Kind Medical Supplies $1,682,512

Contract Services $110,000

TOTAL PROGRAM SERVICES $2,387,937

General and Administrative $62,062

Fundraising $13,173

TOTAL EXPENSES $2,463,172

Decrease in Unrestricted Net Assets ($9,304)

Net Assets - Beginning of Year $188,405

Net Assets - End of Year $179,101

lIABIlITIes AND NeT AsseTs

Credit Card Payable $ 1,496

Payroll Taxes Payable $7,717

Accrued Expenses $10,750

Total Liabilities $19,963

Net Assets - Unrestricted $179,101 Total Liabilities and Net Assets $ 199,064

expenses

Program Services: 97% (Research, Education, Summer Camps, Medical Supplies)

Fundraising: .5%

Administrative: 2.5%

Complete financial statement audited by Eric Bolin, CPA, P.C. available on request

13

Aaron HildenAlfreda CarpenterAllan BleyAlonzo Lonnie BrewsterAngela AddonizioAnna Betsy WhitmerArnold SchwartzBeatrice AlvaradoBenton B. PerryBernard Jay FaverBetty GuyBetty J. BirchettBill PlourdeBillye Jean AllenBryant Lee JewellByron Kirk McAllisterCara WrightCarl StreinCaroline ObadiahCarrie WeigelCharles SobolCharlotte ShraderChristopher TavlaridesChristopher WilsonColette F. FennessyColleen NielsonDarrell Earl MoffettDavid SasicarioDavid SchiffDiana Nevers MooneyDiane DobozynskiDonald L. WillettDonald W. BourneDonna Fish HaynesDonna SalmonDoris V. MillerDorothy Augugliaro (Gorski)Dr. William MarekDuncan McDougallEdith GrossmanEdmond Mike PetroskyEl-Said ShalabyEleonora Reszka DoktorczykEllen Ruth ReddittErin MarcusErma BiedermanEthel EricksonEvelyn GehringerFrances A. MatthewsFrancis DallFrancis PacigaGail LeftonGene ErbaGeorge CashaGeorge RakociGerald O. KankaalaGeraldine Opal LeverenzGil McWilliams, Sr.Gilbert WellerGlenna GlauberGloria Morgan RawlsGuy PinterGuy William Hart

Gwendolyn Maxine HeastyHarry PirlotHelen BuckiHelen ColluraHenry RomanHerbert WilkinsIrene I. SwienczykIzabella DolataJames BrennanJames FIeldJames GalarowiczJames L. DambacherJames M. SheppardJames N. MillerJames WallaceJason Jangsik LeeJean GenglerJeff WestbyJeketha BelingerJim BarbreJimmy CiarcioJo-Ann PittJoan Pauline JacksonJoanne AdamsJohn FerrandoJohn GiddensJohn LeeJohn V. TzourasJon HayesJudith ChaseJudith LamarJulius & Ruth MeisteKathy PostKevin DooleyLaurie ClarkLin Kou TsanLois RaphaelLorraine ErnstLorraine LeeLouise Pecikonis TaliaLynn Marie RiversLynn WilsonMabel K. UnsinnMadeline JewellMargaret Lisa BeckmannMargarete Sylvia RockMark NussmeyerMartin ShawMary Anne AndersonMary BrandauMary WestfallMichael Del SordoMichael P. AllenMiguel A. ColonMina KupfermanMr. Carrol CraigMrs. Debra L. SpectorMrs. William (Jane) ChaseNancy LawrenceNecip Nej SimerNeil FeroOllie DemchukPaul Kenneth Bunce

AcknowledgementsDiabetes Action is deeply grateful to the following donations made in memory or in honor of a loved one.

2013 memorial ContributionGifts made in loving memory of:

Adam BavifardAlbert Ng, Cheow LengAndy AndrewsAnna Maria GapuzShirley SlotnikBrian PhelpsCarol ReeseCharles J. ThomasChristie TrudoChristopher and Annette CookCindy KelsoClaire SchneiderDavid Marino and Elizabeth KimDavid W. WilliamsDavid WinmillDesiree McNameeDevin GodfreyDiane DobozynskiDolores (June) KrahnDonna MitchellDonna LlevitzDr. Vanatus NwagweEarle & Gwyn HicksElaine SimpsonElizabeth LazdinsEllen SeidenfrauEvan HaskellGary HidalgoGreg & Megan SheldonGriffin CristeHeidi KobbInfor HealthcareJack LaneJames GarelickJames McLinn

James NewellJanice SharmaJeff SmithJill LeffKrissy FergusLa Vonne BooneLainee and Roye GinsbergLee PeltzmanLisa & Bob HephnerMark C. DenchyMary & Bill RawsMary Beth Fitts and Greg KopschMelanie HargroveMiddleswart FamilyMr. and Mrs. Louis J. StempflyMrs. Mary Margaret McGuireNabeel ZafarPaige and Keith OrgelPaul ScrantonPaula LeedsRachel MoserRaechel AdamsReeves FamilyRichard HolcombeRichard PriceRobby MinovitzRonald RippsRosanne and James TestaRosemarie and Alfred TellaSean H. DoyleShirley SmithSue and Joe ButlerSue McIntoshSydney LevinThomas Johnson

2013 Honorary ContributionsGifts were made in honor and celebration of:

Sindhu AbrahamCristine AleJoy BarbreJohn and Margaret BrookeRobert and Cynthia BunkerJoseph CampbellIan CarnathanTom and Dee CrosbyThomas CrosbyBrad DefenbaughThomas Egan Digges TrustJill and Dan DionAmerican Dream BuildersWeissman Family FoundationFiber-Line Inc.Mr. and Mrs. Robert C. ForchheimerEquifax FoundationPoker Gives FoundationVarina Lions ClubMegan Graber and Greg SheldonPatricia GrahamStephanie HansenKenneth HarropKensington Capital HoldingsSolomon KornbluhKarl Laun

Christopher MaffrisMilton and Tamar Maltz Family FoundationCarl and Julie ManelloSamuel MarcusJeffery MartinTom McKeithenVincent MeisteRica MisraTroy MoffettAnand NairWilliam NapiecinskiWilson NgJohn NolanTom OlsenJennifer PaulJanet PetersenAnthony PetruzziMary A. ReyburnRenee RossiDennis SamuelSusan SmithSusan StanfieldAbby SteeleBarbara Lee StifflerMarilyn SwannPierre and Kay Gaston TteeYvonne and John VasicekMark ViehmeyerKatherine ViveirosJohn Webb

Thank you to our most generous donors (partial listing)

A special thanks to the many Federal Employees and Military Personnel that donated through the Combined Federal Campaign and to the participants of state and corporate campaigns across the country.

Paul CrowePaula L. BaumgardnerPauline WrightPhyllis OBanionPriscilla StalkerRaymond M. SteadRichard K. InsognaRichard SingletonRichard WaggonerRobert B. CloudRobert Bruce HaldemanRobert CartwrightRobert J. EverheartRobert KressRobert L. KwiatkowskiRosario Gomez CruzRose SoultanianRuby RetcherRussell KlineRussell L. EvinrudeSadie RobinsonSam Misuraca

Sandra B. FitzgeraldSandra LaParlSandra SchwartzSaul CayneSimon Edwin AllemanSonia LeopoldSonia RosickiThomas MorrisonTimothy HudsonTom FisherTony VannTrish ClearyVirginia I. AsikainenVivian DunnVondelle Graef MartinWarren BayletWilliam Bill MoffettWilliam JoyntWilliam McIntyreWilliam P. PetersonYvonne Myers

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Diabetes Action 6701 Democracy Blvd., Suite 300 Bethesda, MD 20817 PHONe 202.333.4520 www.diabetesaction.org

How You Can HelpYour support ensures the advancement of Diabetes Actions mission to prevent and cure diabetes.

Donate OnlineMake a general donation or pay tribute to a loved one.

matching GrantsMany businesses sponsor matching grant programs. Ask your employer if they offer a matching grant program to multiply the value of your contribution.

Workplace or CfC CampaignLook for Diabetes Action Research and Education Foundation in your campaign directory. Even a small contribution per paycheck will make a difference.

Planned GivingIncluding Diabetes Action as a beneficiary in your will or life insurance policy is a generous way to leave a legacy of hope.

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