Mechanisms should be established to support research on drug and biologic development that will not be supported by industry. For example, expansion of programs such as the NIH-supported Type 1 Diabetes Rapid Access to Intervention Development (T1D-RAID) program, and establishment of clinical trial networks, would allow potential therapies to be developed and tested in early Phase I and II trials that could lead to NIH ...more »
Translation of the knowledge of the molecular consequences of diabetes to effective therapies requires better measures of disease progression, faithful models of the molecular and cellular pathology, and application of cutting-edge technologies. Validated biomarkers and surrogate end points will allow rapid screening of clinical interventions prior to larger clinical trials, and can assess risk factors and treatment adequacy ...more »
The value of currently available urine biomarkers that identify those at risk for diabetic nephropathy is increasingly called into question. The development of new urine and plasma biomarkers to predict diabetic nephropathy may shed light on disease mechanisms. Also, rational clinical trial design will be made possible by such markers.
Failure of ACE inhibitors in advanced diabetic nephropathy is an increasing problem. Studies suggest that it is due to aldosterone breakthrough. The mechanism for this escape mechanism is unclear.