In an Anniversary Year, Diabetes Care Takes a Selfie

This issue marks Diabetes Care’s 40th anniversary. The journal’s first issue appeared in January 1978, with Jay Skyler as the cofounding Editor in Chief (EIC). Five of the 14 contributions to the issue concerned urine testing for glucose (1), and we were all much younger. To commemorate this historic event we will present in an upcoming issue, as a “Profile in Progress,” the story of this no-longer-young journal and how, over time, it has evolved into a life of its own, transcending the many individuals who have worked for and contributed to it.

In recent January issues of Diabetes Care it has been customary for the EIC to comment on the state of the journal (2). On this occasion, having completed my first year in this role, I propose to begin by celebrating the announcement made in July that Diabetes Care had earned the highest impact factor ever attained by an American Diabetes Association (ADA) journal. The journal’s score for this index of influence increased from 8.9 the prior year to 11.9 in 2017, higher than that of all other journals focused exclusively on diabetes. It is a remarkable increase, and if I were a crafty politician I would claim all credit because it was announced soon after my appointment as EIC. But, in truth, this achievement resulted from the work of William T. Cefalu, the outgoing EIC, and the outstanding associate editors (AEs) and editorial staff during the last 2 years. It is likely also related to the increase of interest in diabetes itself. The diabetes community is clearly looking to us to present the newest and best research and commentary. I believe that in 2017 we have been able to meet that expectation, with articles that match or exceed those in previous years. Moreover, circulation of the journal’s print editions remains high, the website received 12 million page views in the last year, and our financial status continues to satisfy our managerial colleagues in the ADA. And, just possibly, we can do even better.

How can we improve in 2018? To lay a plan, it may help to consider who we represent and what we aim to accomplish. The ADA, Diabetes Care, and the greater diabetes community are all composed of people with widely varying backgrounds, interests, needs, and skills. Among the ADA’s several journals, Diabetes Care holds a central position between the laboratory and animal studies presented by Diabetes and the clinical topics featured by Clinical Diabetes and Diabetes Spectrum. We are expected to inform our readers how insights from basic research can be translated, through clinical research, into better care for people with diabetes. To address a question often posed to me—what is Diabetes Care looking for in a submission?—I offer the following answers. We are interested in all kinds of human scientific inquiry regarding diabetes: epidemiology, physiology, pharmacotherapeutics, behavioral interventions, health system research, and public health. We aim to report successful translation of science into action, drawing on the work of basic scientists, clinical researchers, clinical endocrinologists, diabetes educators, and other health care specialists. It is a broad range of scientific inquiry and requires a lot of collaboration. We want the best-designed and best-executed studies, with balanced analysis and discussion of their implications. Above all, we value novelty—new ideas that will lead to greater success in treatment of individual patients. Even a beautifully conceived project may be of lesser interest if it offers nothing new.

Starting with these principles, we do not expect to make large changes in format in 2018. This has already been improved and extended in recent years, as was well described in last year’s January issue (2). Each issue will include a selection of original articles, some of them highlighted by expert commentaries. Each issue will also contain special features, including review articles and perspectives on topics of high interest, official statements by the ADA, and reports of consensus conferences and expert forums. Some issues will have a special focus, with groups of original reports and commentaries on a particular aspect of diabetes research or management. But, despite little change in format, we will strive for even better quality in each article published. In an age of electronic overload, everyone is deluged by repetitive, confusing, or unreliable information. What appears in Diabetes Care should be novel, clear, and trustworthy. This will require even greater attention to selecting manuscripts, obtaining reviews that help authors improve their reports, and carefully copyediting the final versions. It’s a lot of work, but our community deserves the best.

So, what will be new in 2018? To more broadly meet the needs of people with diabetes, we hope to expand in two important areas. The first concerns diabetes as a global problem. It is estimated there are ∼30 million people with diabetes in the U.S. (3), but the global total is over 400 million (4). About 70% of the articles submitted to Diabetes Care come from outside the U.S. Although we are part of the ADA, our stated mission is “to increase knowledge, stimulate research, and promote better management of people with diabetes,” without limitation by their national origin or place of residence. While people with diabetes around the world have both genetic and cultural differences, they are more alike than different. Likewise, there is a global community of scientists and clinicians. Already 2 of our 15 AEs are from outside the U.S., as are many members of the editorial board and many reviewers of manuscripts. Their numbers are likely to increase. While continuing to report scientific and clinical concerns and progress in the U.S., we aim to increase attention to diabetes worldwide and to collaborate with experts everywhere.

Results of one such global initiative appear in this issue as a report of the Diabetes Care Editors’ Expert Forum held in June 2016 (5). The topic addressed by this forum was the status of large cardiovascular outcomes trials, especially the question of how to improve their power and generalizability while limiting costs. These trials require thousands of participants from many countries and, appropriately, 5 of the 13 expert panelists convened were from outside the U.S. Improving and harmonizing the designs of clinical trials performed globally are important goals. Our usual limits for words, illustrations, and references had to be expanded to accommodate this ambitious review of past experience and future options.

The broad field of information technology is another area into which Diabetes Care aims to extend its presence. Tools based on new technologies have the potential—not yet fully realized—to improve both research and clinical care while limiting costs. These include electronic medical records; smart glucose-sensing and drug-delivering devices; and communication systems to link patients, providers, researchers, and community resources. For example, in the December 2017 issue we featured progress in the use of continuous glucose monitoring systems (6). These devices will facilitate research into relationships between glycemic patterns and the complications of diabetes and also help individualize treatment for patients. At the upcoming ADA Scientific Sessions in June in Orlando, both the annual Diabetes Care Symposium and a Diabetes Care Editors’ Expert Forum will address the use of new systems based on digital technologies. We plan to introduce a new section on such topics for each issue of Diabetes Care at some time in the coming year.

At the beginning of this anniversary year Diabetes Care is both looking back and gazing forward, as well as taking a snapshot of itself—in modern terms, a “selfie.” It is humbling for me to be invited to assume leadership of the journal, following the distinguished former EICs. To give credit where credit is due, Fig. 1 presents photographs of the eight prior EICs. I also want to take this opportunity to recognize the current AEs and ad hoc EICs (listed in the sidebar); the editorial staff in Indianapolis, Indiana; and the production staff in Arlington, Virginia. They are the ones who are doing the actual work at this moment in time. We all appreciate the past, present, and future contributions and support from our many friends in the diabetes community.