Progress in the field of diabetes comes from many sources, including novel ideas, research breakthroughs, expanding therapeutic options, technological advances, charismatic personalities, and enhanced communication between the scientific and clinical communities. It is in the latter realm that the American Diabetes Association’s (ADA’s) journal Diabetes Care has played an increasingly important role since its founding in 1978. Through the years, the journal has grown to become both a locus for and stimulus of all the other sources of progress in diabetes clinical research and care. From its inaugural year, during which there were concerns about how to fill six issues and an acceptance rate just under 50% (1), to its present 41st volume year, with monthly issues ∼3,000 submissions annually, and an acceptance rate for original articles of under 10%, Diabetes Care has emerged as the premier journal in its field.

The 1970s were a busy time in diabetes research that ushered in numerous transformative advances, supported by a marked increase in research funding from the National Institutes of Health (NIH) (2). The role and influence of the ADA were also broadening to include a greater focus on patient care, nursing practice, health care delivery, and professional education (3). Against this backdrop, ADA professional members began to wonder whether the association’s journal Diabetes (established in 1952) adequately addressed the needs of clinical investigators and clinicians treating patients with the disease. A committee appointed to study the question commissioned a physician survey that confirmed strong interest in a clinically oriented diabetes journal. Soon thereafter, Diabetes Care was launched. The second word of its title was an acronym for its focus on Clinical and Applied Research and Education (2).

In the 40 years since, annual submissions have increased more than 17-fold, the number of published articles has grown by more than 9-fold, and total pages have expanded more than 10-fold (Fig. 1). This growth reflects not only the increase in diabetes prevalence to epidemic levels worldwide, but also the journal’s well-deserved reputation as a prestigious venue for publishing in the field of diabetes clinical care.

Figure 1

Number of articles published, articles submitted, and printed pages for selected years, 1978–2013.

Figure 1

Number of articles published, articles submitted, and printed pages for selected years, 1978–2013.

Close modal

More important than the quantitative evidence for Diabetes Care’s characterization as a “Profile in Progress,” however, is the qualitative development of its contents and the ways in which it has influenced the course of diabetes clinical research and care. One way such influence is estimated is through a journal’s impact factor. Impact factors are used to gauge the importance of a journal based on how frequently its articles are cited in the wider literature. Table 1 lists the annual impact factors for Diabetes Care, starting with the earliest available impact factor of 3.148 in 1991. The most recent impact factor of 11.857 for 2016 is the highest ever achieved by an ADA journal, giving Diabetes Care the rank of fifth among 138 rated endocrinology and metabolism journals and making it the top-ranked and most-cited journal devoted exclusively to diabetes.

Table 1

Diabetes Care impact factors and citations per year, 1991–2016

Impact factor*Total citations
1991
 
3.148
 
NA
 
1992
 
4.026
 
NA
 
1993
 
3.164
 
NA
 
1994
 
2.755
 
NA
 
1995
 
2.526
 
NA
 
1996
 
3.457
 
NA
 
1997
 
3.321
 
9,186
 
1998
 
4.180
 
11,063
 
1999
 
5.076
 
12,409
 
2000
 
4.992
 
13,191
 
2001
 
5.404
 
15,394
 
2002
 
5.477
 
15,982
 
2003
 
7.501
 
21,164
 
2004
 
7.071
 
23,635
 
2005
 
7.844
 
27,563
 
2006
 
7.912
 
30,486
 
2007
 
7.851
 
35,824
 
2008
 
7.349
 
40,826
 
2009
 
6.718
 
43,007
 
2010
 
7.141
 
42,325
 
2011
 
8.087
 
44,452
 
2012
 
7.735
 
49,025
 
2013
 
8.570
 
52,771
 
2014
 
8.420
 
56,103
 
2015
 
8.934
 
60,339
 
2016 11.857 66,107 
Impact factor*Total citations
1991
 
3.148
 
NA
 
1992
 
4.026
 
NA
 
1993
 
3.164
 
NA
 
1994
 
2.755
 
NA
 
1995
 
2.526
 
NA
 
1996
 
3.457
 
NA
 
1997
 
3.321
 
9,186
 
1998
 
4.180
 
11,063
 
1999
 
5.076
 
12,409
 
2000
 
4.992
 
13,191
 
2001
 
5.404
 
15,394
 
2002
 
5.477
 
15,982
 
2003
 
7.501
 
21,164
 
2004
 
7.071
 
23,635
 
2005
 
7.844
 
27,563
 
2006
 
7.912
 
30,486
 
2007
 
7.851
 
35,824
 
2008
 
7.349
 
40,826
 
2009
 
6.718
 
43,007
 
2010
 
7.141
 
42,325
 
2011
 
8.087
 
44,452
 
2012
 
7.735
 
49,025
 
2013
 
8.570
 
52,771
 
2014
 
8.420
 
56,103
 
2015
 
8.934
 
60,339
 
2016 11.857 66,107 

*Impact factors are based on the previous 2 years’ citations and first became available for Diabetes Care in 1991. NA, not available.

Much of this success can be attributed to the vision and dedication of the nine men who have served as the journal’s editors in chief through the years (who are profiled in Fig. 2), as well as their teams of associate editors. Credit is also due to the many scientists and clinicians who have submitted their research and served as reviewers.

Figure 2

Editors in chief of Diabetes Care.

Figure 2

Editors in chief of Diabetes Care.

Close modal

To better explain the steady rise in stature and influence of Diabetes Care over time, we provide below a discussion of some of the key articles published in each decade. These articles, though subjectively selected, illustrate the breadth, diversity, maturation, and increased scientific rigor with which Diabetes Care has contributed to the dialogue between researchers and diabetes care providers through the years.

The 1970s saw numerous advances in the field of diabetes, including the development of purified insulin and the first insulin pump, the advent of self-monitoring of blood glucose (SMBG), the widespread use of A1C testing, the emergence of specialized diabetes educators, and the ascent of the multidisciplinary team approach to clinical care. From its inception in 1978, Diabetes Care focused on publishing peer-reviewed articles on such topics (2).

Among the articles in its first issue (Fig. 3) were a research report on the glycemic effects of jet-injected insulin (4), a review of glycemic management in pregnancy complicated by diabetes (5), and an early description of pancreas transplantation (6). Later that year, an article translated from French and reprinted in two parts from Diabete et Metabolisme (7,8) provided impressive albeit somewhat crude evidence suggesting that better glycemic control might reduce the long-term complications of diabetes. By the end of its first year, Diabetes Care had been selected for inclusion in Index Medicus and the MEDLARS online database (1).

Figure 3

Inaugural issue of Diabetes Care, January/February 1978.

Figure 3

Inaugural issue of Diabetes Care, January/February 1978.

Close modal

In 1979, the journal published preliminary results of continuous pump-infused subcutaneous insulin for type 1 diabetes (9), an introduction to A1C testing to document chronic hyperglycemia in children (10), and an article written by an engineer with type 1 diabetes who had used an early glucose meter throughout the decade and developed several refinements in technique to improve the utility of SMBG (11).

Although such early reports often involved small numbers of individuals, they served to alert physicians, nurses, and other professionals on the frontlines about treatment innovations that would eventually benefit countless patients. The contents of the first two volumes of Diabetes Care attest to its editorial team’s intention to position the journal on the leading edge of progress.

By the early 1980s, submissions were on the rise, and in 1988, the publication expanded to 10 issues per year. Its contents in this decade reflected growing interest in improving the efficacy and safety of insulin therapy, encouraging the proliferation of SMBG, and supporting patient self-management more broadly.

In 1980, the journal published the proceedings of the Kroc Foundation International Conference on Insulin Delivery Devices (12), an expert workshop exploring the potential for development of novel insulin delivery devices, including improved pumps, an artificial pancreas system, and a fully implantable delivery device. The conference chairman emphasized that progress in insulin administration must occur in tandem with progress in the monitoring of glycemic control. Toward that end, the journal that year also published an international symposium on home blood glucose monitoring that examined the accuracy and costs of various methods of SMBG and marked a new era in which tight glycemic control “will be both valid and achievable to a degree not before approximated except for the briefest time… in a laboratory setting” (13).

By mid-decade, five glucose meters were available for home use, and an article of great practical application compared the accuracy, ease of use, costs, and availability of supplies for each, summarizing the advantages and disadvantages clinicians should consider before making recommendations to their patients (14).

As intensive insulin therapy became more common, concerns about hypoglycemia increased. A 1983 review described sophisticated studies of hypoglycemia and its counterregulation (15), and a 1985 original report examined the frequency, causes, and prevention of hypoglycemia, drawing attention to the dangers of this acute complication and the need for better patient education about its treatment and prevention (16). The journal also published articles elucidating the benefits of insulin in type 2 diabetes, including an early report on the reversal of insulin resistance through insulin therapy (17).

Diabetes Care also encouraged greater scientific rigor in fields such as behavioral modification and education. A 1983 report of a randomized trial comparing group and individual nutritional counseling exemplified this, using objective measures of metabolic outcomes and changes in body weight to evaluate differences between the two approaches (18). As more emphasis was placed on patient self-management, the journal also published criteria for validating tests of patients’ knowledge (19) and an assessment of diabetes-related knowledge among the nurses charged with their care and education (20). Meanwhile, readers were kept well informed on advances in basic science through reviews on topics such as C-peptide (21) and the pathophysiology of insulin secretion (22).

In 1987, the Diabetes Control and Complications Trial (DCCT) investigators chose to submit the critical results of their feasibility trial to Diabetes Care (23). Their data demonstrated that type 1 diabetes patients could be randomly assigned to an intensive or standard treatment regimen and maintain glucose levels far enough apart to determine whether retinopathy would develop or progress more slowly with intensive treatment and at what clinical cost. Although the main DCCT results were published 6 years later in a journal with broader readership, 51 of the 259 subsequent articles from this landmark trial have appeared in Diabetes Care. Most important among them was the 2016 follow-up report demonstrating that, over 28 years, mortality in the trial’s intensively managed cohort did not differ significantly from that in a matched group without diabetes (24).

June of 1989 brought an important new feature to the journal: the first edition of ADA’s Standards of Care position statement (25); in January 1990, the journal also began publishing an annual compendium of current ADA position and consensus statements collectively known as the Clinical Practice Recommendations. Updated annually or as needed by the ADA Professional Practice Committee, these publications have been among the most authoritative and influential evidence-based guidelines for diabetes management in the world. In recent years, they have been consolidated into a single, cohesive, multiple-chapter supplement, the most recent of which was published in January (26).

Throughout its first full decade, Diabetes Care helped to opened the door to better understanding of the pathophysiology of diabetes, the benefits of SMBG, the mechanisms of insulin action, and the complex relationship between glucose and insulin. The diabetes community was learning more about hyperglycemia and its association with long-term complications, and the journal was at the forefront of disseminating this knowledge.

In 1990, Diabetes Care began producing 12 issues per year. Early in the decade, the journal published a definitive description of insulin resistance syndrome, which includes a cluster of metabolic disorders (diabetes, dyslipidemia, hypertension, and cardiovascular risk), that highlighted the need to define the mechanisms responsible for the defect in insulin-mediated glucose metabolism (27). At the end of the decade, the journal published a report on a novel method for estimating whole-body insulin sensitivity that was simple to calculate and provided a credible approximation from data obtained via oral glucose tolerance testing (28).

In addition to pathophysiology, the diabetes community at that time was also focused on epidemiology and prevention. In 1993, the journal published an article on standardized global estimates of the prevalence of abnormal glucose tolerance in adults (29). The information in that article, based on surveys collected from 75 communities in 32 countries, provided the first comparable data on rates of diabetes and impaired glucose tolerance (IGT) around the world. A later report estimated future diabetes prevalence worldwide and supported earlier predictions of epidemic expansion of the disease through the first quarter of the 21st century (30). These articles were a call to action on the urgent priority of diabetes prevention.

Other groundbreaking reports also had major implications for the prevention of type 2 diabetes and its long-term consequences. The 1993 MRFIT (Multiple Risk Factor Intervention Trial), an early, large, 12-year cardiovascular risk study in men, confirmed diabetes as a strong independent risk factor for cardiovascular mortality beyond the effects of elevated cholesterol, hypertension, and smoking (31). In 1997, the journal published the results of the first large-scale, controlled trial of lifestyle intervention for type 2 diabetes prevention. The groundbreaking Da Qing IGT and Diabetes Study (32) showed that dietary modification, exercise, or both reduced the development of diabetes compared with a control condition of no intervention in high-risk Chinese adults with IGT. This was the first of numerous trials conducted around the world that demonstrated the viability of lifestyle modification and various pharmacological interventions for preventing type 2 diabetes.

The 1990s also marked the beginning of a rapid expansion of the diabetes armamentarium, and the proliferation of new drugs and new drug classes was chronicled in the journal (3336), including descriptions of the efficacy of metformin (34) and a report on the efficacy and safety of glimepiride, a modern sulfonylurea that has since become a widely used treatment option (35). As new drug development gained momentum, the need for accurate blood glucose monitoring became even more crucial, especially with regard to detecting hypoglycemia, and this issue was also addressed (3638).

The rising cost of treating diabetes was not lost on the editors of Diabetes Care. Having earlier taken up the issue of insurance reimbursement for diabetes education and therapeutic technologies (39), they continued to focus on the economics of diabetes. One article used computer modeling to estimate that the federal government saved nearly $250 million annually and nearly 54,000 person-years of sight by providing preventive eye care to the 60% of people with type 2 diabetes who at that time received such services (40). It further estimated that reaching all patients would save more than $472 million and >94,000 patient-years of sight (40). Such articles had important implications for health care reform.

The first decade of the millennium brought refinements to clinical research, advances in therapeutics, and a focus on diabetes diagnosis and epidemiology. In 2000, the journal published important evidence supporting HOMA of insulin sensitivity as a reliable surrogate for in vivo measurement in humans (41). A later article further clarified the strengths and weaknesses of this method (42), which is now widely used to determine insulin sensitivity and β-cell function in large-scale trials. Diabetes Care continued to publish articles about pharmacotherapeutic advances, including the influential Treat-to-Target Trial of basal insulin replacement in patients with type 2 diabetes inadequately controlled with oral agents, which presented a simple, basal-only regimen that facilitated the earlier initiation of insulin therapy for patients with type 2 diabetes (43). Other articles kept readers apprised of emerging oral agents such as pioglitazone (44) and new drug classes such as dipeptidyl peptidase 4 (DPP-4) inhibitors (45,46).

Several epidemiologic studies underscored growing concerns about the diabetes epidemic and the rising costs of diabetes, as well as the need for health care policies to address them. A 2001 article projected a dramatic increase in the burden of diabetes in the U.S. through 2050 (47). Additional articles published from the late 1990s and into the 2000s further demonstrated that glycemic control could be improved in underserved or disadvantaged patients at high risk for complications and discussed how imbalances in access to care, medication adherence, and education, as well as clinical inertia, contribute to poor clinical outcomes (4850). Interest in diabetes during pregnancy was also increasing, as reflected in a 2002 review of the link between gestational diabetes mellitus (GDM) and later development of type 2 diabetes (51), a 2008 report on trends in preexisting diabetes and GDM (52), and another 2008 report examining the possibly protective effects of insulin therapy during pregnancy on the fetal vascular system (53).

The practical application of research in clinical practice continued to be a key focus for the journal. A 2005 review on the diagnosis, prevention, and treatment of nephropathy in diabetes (54), still widely cited today, raised awareness of early screening and diagnosis methods and outlined therapeutic strategies for reno- and cardioprotection in high-risk patients. Other articles provided practical information on new treatments for complications such as neuropathic foot ulcers (55,56) and erectile dysfunction (57). A 2008 systematic tabulation of data on the glycemic index and glycemic load values of nearly 2,500 foods became a useful resource for researchers and clinicians alike (58).

Over time, Diabetes Care became a key venue for articles reporting on the design and results of important randomized clinical trials (5961), allowing readers the opportunity to anticipate progress and judge the value of emerging interventions.

The final year of this decade brought another influential paper to the journal: the consensus report of an international expert committee convened by ADA, the European Association for the Study of Diabetes (EASD), and the International Diabetes Federation (IDF) to consider current and future methods of diagnosing diabetes (62). The committee’s recommendations favoring the use of the A1C assay for diagnosis appeared in Diabetes Care in 2009 (62) and were adopted in the following year’s ADA Clinical Practice Recommendations (63).

Now in its fourth decade, Diabetes Care has continued to innovate by introducing several new programs and features to provide readers with a more holistic, big-picture view of key topics in clinical research and care.

June 2012 marked the first of what would become an annual Diabetes Care Symposium, held in conjunction with ADA’s Scientific Sessions. These signature events are among the most well-attended programs at each year’s meeting, with presentations representing landmark trials and innovative clinical and translational studies that challenge current paradigms of diabetes treatment or present evolving management strategies. The most recent symposium, in June 2017, featured four world-renowned experts (including the founding and current editors of the journal) who were invited to present their views on the current status and future development of diabetes management, with an emphasis on cardiovascular disease.

Diabetes Care Editors’ Expert Forums are another relatively recent addition to the journal. For these programs, the journal convenes an expert panel to discuss a timely topic in diabetes clinical management and then publishes a paper reflecting the consensus viewpoints emerging from the forum. The most recent forum, on the topic of cardiovascular outcomes trials (CVOTs) in type 2 diabetes, was published in the January 2018 issue of Diabetes Care and provides a comprehensive review of completed and ongoing CVOTs and recommendations for enhancing the value of future trials (64).

In 2013, the journal launched another novel feature: special-topic article collections. The first such collection featured articles from the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study providing data on the efficacy and safety of treatment, as well as the rate of complications and the progression of risk factors, in the growing population of youth with type 2 diabetes (65). Table 2 contains a list of the Diabetes Care symposiums, expert forums, and special-topic collections to date.

Table 2

Diabetes Care Symposiums, Editors’ Expert Forums, and special-topic article collections

Issue of publication
Diabetes Care Symposiums
 
 “Innovative Concepts and Evolving Clinical Management Strategies in Diabetes Care”
 
July 2012
 
 “Innovative Studies That Challenge Current Paradigms of Diabetes Treatments”
 
July 2013
 
 “New Drug Therapies, Innovative Management Strategies, and Novel Drug Targets”
 
July 2014
 
 “Novel Clinical Interventions in Therapy That Impact the Management of Diabetes”
 
July 2015
 
 “Novel Clinical Strategies in the Management of Diabetes”
 
July 2016
 
 “Diabetes Research and Care Through the Ages”
 
September 2017
 
Diabetes Care Editors’ Expert Forums
 
 “Personalized Management of Hyperglycemia in Type 2 Diabetes: Reflections From a Diabetes Care Editors’ Expert Forum”
 
June 2013
 
 “Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
 
June 2014
 
 “Beyond Metformin: Safety Considerations in the Decision-Making Process for Selecting a Second Medication for Type 2 Diabetes Management: Reflections From a Diabetes Care Editors’ Expert Forum”
 
September 2014
 
 “Advances in the Science, Treatment, and Prevention of the Disease of Obesity: Reflections from a Diabetes Care Editors’ Expert Forum”
 
August 2015
 
 “Update and Next Steps for Real-World Translation of Interventions for Type 2 Diabetes Prevention: Reflections from a Diabetes Care Editors’ Expert Forum”
 
July 2016
 
 “Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections from a Diabetes Care Editors’ Expert Forum”
 
January 2018
 
Special-topic article collections
 
 “TODAY Study: The Changing ‘Face’ of the Type 2 Diabetes Epidemic”
 
June 2013
 
 “A Critical Review of the Risks and Benefits of Incretin-Based Therapies”
 
July 2013
 
 “DCCT/EDIC 30th Anniversary Summary Findings”
 
January 2014
 
 “Current Concepts of Type 2 Diabetes Prevention”
 
April 2014
 
 “Advances in Artificial Pancreas Development”
 
May 2014
 
 “Understanding and Addressing Health Disparities in Diabetes Care and Research”
 
February 2015
 
 “Evolving Tactics With Inhibition of Sodium–Glucose Cotransporters”
 
March 2015
 
 “Type 1 Diabetes at a Crossroads”
 
June 2015
 
 “Guiding Principles for Diabetes Care”
 
October 2015
 
 “Insulin After More Than 90 Years . . . We Have Come a Long Way!”
 
December 2015
 
 “IDF-ADA Symposium: Translational Diabetes Research With Immediate Clinical Impact”
 
January 2016
 
 “Considerations in the Management of Gestational Diabetes Mellitus”
 
January 2016
 
 “Cardiovascular Diseases and Diabetes”
 
May 2016
 
 “Metabolic Surgery and the Changing Landscape for Diabetes Care”
 
June 2016
 
 “The Artificial Pancreas in 2016: A Digital Treatment Ecosystem for Diabetes”
 
July 2016
 
 “Emerging Science, Concepts, and Approach to Precision Medicine”
 
November 2016
 
 “Psychosocial Research and Care in Diabetes”
 
December 2016
 
 “Emerging Science and Concepts for Management of Diabetes and Aging”
 
April 2017
 
 “Continuous Glucose Monitoring and Risk of Hypoglycemia” December 2017 
Issue of publication
Diabetes Care Symposiums
 
 “Innovative Concepts and Evolving Clinical Management Strategies in Diabetes Care”
 
July 2012
 
 “Innovative Studies That Challenge Current Paradigms of Diabetes Treatments”
 
July 2013
 
 “New Drug Therapies, Innovative Management Strategies, and Novel Drug Targets”
 
July 2014
 
 “Novel Clinical Interventions in Therapy That Impact the Management of Diabetes”
 
July 2015
 
 “Novel Clinical Strategies in the Management of Diabetes”
 
July 2016
 
 “Diabetes Research and Care Through the Ages”
 
September 2017
 
Diabetes Care Editors’ Expert Forums
 
 “Personalized Management of Hyperglycemia in Type 2 Diabetes: Reflections From a Diabetes Care Editors’ Expert Forum”
 
June 2013
 
 “Insulin Therapy in People With Type 2 Diabetes: Opportunities and Challenges?
 
June 2014
 
 “Beyond Metformin: Safety Considerations in the Decision-Making Process for Selecting a Second Medication for Type 2 Diabetes Management: Reflections From a Diabetes Care Editors’ Expert Forum”
 
September 2014
 
 “Advances in the Science, Treatment, and Prevention of the Disease of Obesity: Reflections from a Diabetes Care Editors’ Expert Forum”
 
August 2015
 
 “Update and Next Steps for Real-World Translation of Interventions for Type 2 Diabetes Prevention: Reflections from a Diabetes Care Editors’ Expert Forum”
 
July 2016
 
 “Cardiovascular Outcomes Trials in Type 2 Diabetes: Where Do We Go From Here? Reflections from a Diabetes Care Editors’ Expert Forum”
 
January 2018
 
Special-topic article collections
 
 “TODAY Study: The Changing ‘Face’ of the Type 2 Diabetes Epidemic”
 
June 2013
 
 “A Critical Review of the Risks and Benefits of Incretin-Based Therapies”
 
July 2013
 
 “DCCT/EDIC 30th Anniversary Summary Findings”
 
January 2014
 
 “Current Concepts of Type 2 Diabetes Prevention”
 
April 2014
 
 “Advances in Artificial Pancreas Development”
 
May 2014
 
 “Understanding and Addressing Health Disparities in Diabetes Care and Research”
 
February 2015
 
 “Evolving Tactics With Inhibition of Sodium–Glucose Cotransporters”
 
March 2015
 
 “Type 1 Diabetes at a Crossroads”
 
June 2015
 
 “Guiding Principles for Diabetes Care”
 
October 2015
 
 “Insulin After More Than 90 Years . . . We Have Come a Long Way!”
 
December 2015
 
 “IDF-ADA Symposium: Translational Diabetes Research With Immediate Clinical Impact”
 
January 2016
 
 “Considerations in the Management of Gestational Diabetes Mellitus”
 
January 2016
 
 “Cardiovascular Diseases and Diabetes”
 
May 2016
 
 “Metabolic Surgery and the Changing Landscape for Diabetes Care”
 
June 2016
 
 “The Artificial Pancreas in 2016: A Digital Treatment Ecosystem for Diabetes”
 
July 2016
 
 “Emerging Science, Concepts, and Approach to Precision Medicine”
 
November 2016
 
 “Psychosocial Research and Care in Diabetes”
 
December 2016
 
 “Emerging Science and Concepts for Management of Diabetes and Aging”
 
April 2017
 
 “Continuous Glucose Monitoring and Risk of Hypoglycemia” December 2017 

In addition to these innovative projects, the journal has continued its tradition of publishing outstanding research with an emphasis on novel concepts and emerging treatments. A 2010 metaanalysis, for example, reported on a new dietary risk factor for diabetes, showing that greater consumption of sugar-sweetened beverages is associated with not only weight gain and increased obesity risk, but also higher risks for metabolic syndrome and type 2 diabetes (66). In 2011, a report from the Look AHEAD (Action for Health in Diabetes) study provided strong evidence of significant improvement in cardiovascular disease risk factors from modest weight loss (67). And in 2014, an interesting review article summarized available evidence on the challenges faced by people with diabetes who want to participate in physical activities at high altitude (68).

The journal also continued to highlight new procedures and technological advances. A 2012 article described trends in the primary efficacy and safety outcomes of islet transplantation in people with type 1 diabetes (69). In 2014, the journal published results of the first randomized crossover trials of a wearable artificial pancreas system (70), as well as a trial of closed-loop glucagon delivery to prevent hypoglycemia in type 1 diabetes (71). In 2013, an expert point-counterpoint discussion presented arguments for and against the use of incretin-based therapies, given conflicting safety data available at the time (72,73). The impact of intensive insulin treatment on the preservation of β-cell function was highlighted in studies reported in 2012 in patients with newly diagnosed type 2 diabetes (74) and in 2013 in patients with new-onset type 1 diabetes (75). Recent review articles have included a summary of data on natriuretic peptides (76), a history of hyperosmolar hyperglycemic state (77), and an update on the effects of DPP-4 inhibition on microvascular complications (78).

As noted earlier, the articles included in this narrative are by no means exhaustive, nor were they selected in any objective manner. Rather, they were mentioned as outstanding examples of the high-quality research and information disseminated by Diabetes Care throughout the past 40 years and as evidence of the journal’s crucial and ongoing role in facilitating progress in diabetes clinical research and care. Moreover, the contents of Diabetes Care fully reflect the history of diabetes itself over the same period of time.

Acknowledgments. The authors thank Chandra Blazek, Case Western Reserve University, Cleveland, OH, for administrative assistance; Heather Norton Blackburn and Christian S. Kohler, American Diabetes Association, Arlington, VA, for assistance with research and review of the manuscript; Jay S. Skyler, University of Miami Leonard M. Miller School of Medicine, Miami, FL, former editor in chief of Diabetes Care, for sharing knowledge of the history of the journal; and all the former and current editors of Diabetes Care, who provided input and helpful advice. Editorial services for this article were provided by Debbie Kendall, Kendall Editorial, Richmond, VA.

Duality of Interest. L.R. is an employee of the American Diabetes Association, which publishes Diabetes Care. No other potential conflicts of interest relevant to this article were reported.

1.
Skyler
JS
.
Thoughts along the way
.
Diabetes Care
1979
;
2
:
58
59
[PubMed]
2.
Skyler
JS
.
Thirty years of Diabetes Care: reflections on the beginning
.
Diabetes Care
2008
;
31
:
183
184
[PubMed]
3.
Freinkel
N
.
On the birth of a new journal
.
Diabetes Care
1978
;
1
:
70
71
4.
Danowski
TS
,
Sunder
JH
.
Jet injection of insulin during self-monitoring of blood glucose
.
Diabetes Care
1978
;
1
:
27
33
[PubMed]
5.
Mintz
DH
,
Skyler
JS
,
Chez
RA
.
Diabetes mellitus and pregnancy
.
Diabetes Care
1978
;
1
:
49
63
[PubMed]
6.
Gliedman
ML
,
Tellis
VA
,
Soberman
R
,
Rifkin
H
,
Veith
FJ
.
Long-term effects of pancreatic transplant function in patients with advanced juvenile-onset diabetes
.
Diabetes Care
1978
;
1
:
1
9
[PubMed]
7.
Pirart
J
.
Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973
.
Diabetes Care
1978
;
1
:
168
188
8.
Pirart
J
.
Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973: part 2
.
Diabetes Care
1978
;
1
:
252
263
9.
Riley
WJ
,
Silverstein
JH
,
Rosenbloom
AL
.
Ambulatory diabetes management by a pulse of subcutaneous insulin delivered by a portable pump: preliminary report
.
Diabetes Care
1979
;
2
:
272
274
[PubMed]
10.
Jackson
RL
,
Hess
RL
,
England
JD
.
Hemoglobin A1C values in children with overt diabetes maintained in varying degrees of control
.
Diabetes Care
1979
;
2
:
391
395
[PubMed]
11.
Bernstein
RK
.
Blood glucose self-monitoring by diabetic patients: refinements of procedural technique
.
Diabetes Care
1979
;
2
:
233
236
[PubMed]
12.
Eaton
RP
.
Insulin delivery devices
.
Diabetes Care
1980
;
3
:
253
254
[PubMed]
13.
Bleicher
SJ
.
Chairman’s introduction: symposium on home blood glucose monitoring
.
Diabetes Care
1980
;
3
:
57
[PubMed]
14.
Gifford-Jorgensen
RA
,
Borchert
J
,
Hassanein
R
,
Tilzer
L
,
Eaks
GA
,
Moore
WV
.
Comparison of five glucose meters for self-monitoring of blood glucose by diabetic patients
.
Diabetes Care
1986
;
9
:
70
76
[PubMed]
15.
Cryer
PE
,
Gerich
JE
.
Relevance of glucose counterregulatory systems to patients with diabetes: critical roles of glucagon and epinephrine
.
Diabetes Care
1983
;
6
:
95
99
[PubMed]
16.
Casparie
AF
,
Elving
LD
.
Severe hypoglycemia in diabetic patients: frequency, causes, prevention
.
Diabetes Care
1985
;
8
:
141
145
[PubMed]
17.
Scarlett
JA
,
Gray
RS
,
Griffin
J
,
Olefsky
JM
,
Kolterman
OG
.
Insulin treatment reverses the insulin resistance of type II diabetes mellitus
.
Diabetes Care
1982
;
5
:
353
363
[PubMed]
18.
Rabkin
SW
,
Boyko
E
,
Wilson
A
,
Streja
DA
.
A randomized clinical trial comparing behavior modification and individual counseling in the nutritional therapy of non-insulin-dependent diabetes mellitus: comparison of the effect on blood sugar, body weight, and serum lipids
.
Diabetes Care
1983
;
6
:
50
56
[PubMed]
19.
Hess
GE
,
Davis
WK
.
The validation of a diabetes patient knowledge test
.
Diabetes Care
1983
;
6
:
591
596
[PubMed]
20.
Drass
JA
,
Muir-Nash
J
,
Boykin
PC
,
Turek
JM
,
Baker
KL
.
Perceived and actual level of knowledge of diabetes mellitus among nurses
.
Diabetes Care
1989
;
12
:
351
356
[PubMed]
21.
Hoekstra
JBL
,
van Rijn
HJM
,
Erkelens
DW
,
Thijssen
JHH
.
C-peptide
.
Diabetes Care
1982
;
5
:
438
446
[PubMed]
22.
Ward
WK
,
Beard
JC
,
Halter
JB
,
Pfeifer
MA
,
Porte
D
 Jr
.
Pathophysiology of insulin secretion in non-insulin-dependent diabetes mellitus
.
Diabetes Care
1984
;
7
:
491
502
[PubMed]
23.
The DCCT Research Group
.
Diabetes Control and Complications Trial (DCCT): results of feasibility study
.
Diabetes Care
1987
;
10
:
1
19
[PubMed]
24.
Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group
.
Mortality in type 1 diabetes in the DCCT/EDIC versus the general population
.
Diabetes Care
2016
;
39
:
1378
1383
[PubMed]
25.
American Diabetes Association
.
Standards of medical care for patients with diabetes mellitus
.
Diabetes Care
1989
;
12
:
365
368
[PubMed]
26.
American Diabetes Association
.
Standards of Medical Care in Diabetes—2018
.
Diabetes Care
2018
;
41
(
Suppl. 1
):
S1
–S159
27.
DeFronzo
RA
,
Ferrannini
E
.
Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease
.
Diabetes Care
1991
;
14
:
173
194
[PubMed]
28.
Matsuda
M
,
DeFronzo
RA
.
Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp
.
Diabetes Care
1999
;
22
:
1462
1470
[PubMed]
29.
King
H
,
Rewers
M
;
WHO Ad Hoc Diabetes Reporting Group
.
Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults
.
Diabetes Care
1993
;
16
:
157
177
[PubMed]
30.
King
H
,
Aubert
RE
,
Herman
WH
.
Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections
.
Diabetes Care
1998
;
21
:
1414
1431
[PubMed]
31.
Stamler
J
,
Vaccaro
O
,
Neaton
JD
,
Wentworth
D
.
Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial
.
Diabetes Care
1993
;
16
:
434
444
[PubMed]
32.
Pan
XR
,
Li
GW
,
Hu
YH
, et al
.
Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study
.
Diabetes Care
1997
;
20
:
537
544
[PubMed]
33.
Hofmann
CA
,
Colca
JR
.
New oral thiazolidinedione antidiabetic agents act as insulin sensitizers
.
Diabetes Care
1992
;
15
:
1075
1078
[PubMed]
34.
Giugliano
D
,
De Rosa
N
,
Di Maro
G
, et al
.
Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women
.
Diabetes Care
1993
;
16
:
1387
1390
[PubMed]
35.
Rosenstock
J
,
Samols
E
,
Muchmore
DB
,
Schneider
J
;
Glimepiride Study Group
.
Glimepiride, a new once-daily sulfonylurea: a double-blind placebo-controlled study of NIDDM patients
.
Diabetes Care
1996
;
19
:
1194
1199
[PubMed]
36.
Goldberg
RB
,
Einhorn
D
,
Lucas
CP
, et al
.
A randomized placebo-controlled trial of repaglinide in the treatment of type 2 diabetes
.
Diabetes Care
1998
;
21
:
1897
1903
[PubMed]
37.
Tate
PF
,
Clements
CA
,
Walters
JE
.
Accuracy of home blood glucose monitors
.
Diabetes Care
1992
;
15
:
536
538
[PubMed]
38.
Trajanoski
Z
,
Brunner
GA
,
Gfrerer
RJ
,
Wach
P
,
Pieber
TR
.
Accuracy of home blood glucose meters during hypoglycemia
.
Diabetes Care
1996
;
19
:
1412
1415
[PubMed]
39.
Sinnock
P
,
Bauer
DW
.
Reimbursement issues in diabetes
.
Diabetes Care
1984
;
7
:
291
296
[PubMed]
40.
Javitt
JC
,
Aiello
LP
,
Chiang
Y
,
Ferris
FL
 3rd
,
Canner
JK
,
Greenfield
S
.
Preventive eye care in people with diabetes is cost-saving to the federal government: implications for health-care reform
.
Diabetes Care
1994
;
17
:
909
917
[PubMed]
41.
Bonora
E
,
Targher
G
,
Alberiche
M
, et al
.
Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity
.
Diabetes Care
2000
;
23
:
57
63
[PubMed]
42.
Tripathy
D
,
Almgren
P
,
Tuomi
T
,
Groop
L
.
Contribution of insulin-stimulated glucose uptake and basal hepatic insulin sensitivity to surrogate measures of insulin sensitivity
.
Diabetes Care
2004
;
27
:
2204
2210
[PubMed]
43.
Riddle
MC
,
Rosenstock
J
,
Gerich
J
;
Insulin Glargine 4002 Study Investigators
.
The Treat-to-Target Trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients
.
Diabetes Care
2003
;
26
:
3080
3086
[PubMed]
44.
Aronoff
S
,
Rosenblatt
S
,
Braithwaite
S
,
Egan
JW
,
Mathisen
AL
,
Schneider
RL
;
Pioglitazone 001 Study Group
.
Pioglitazone hydrochloride monotherapy improves glycemic control in the treatment of patients with type 2 diabetes: a 6-month randomized placebo-controlled dose-response study.
Diabetes Care
2000
;
23
:
1605
1611
[PubMed]
45.
Drucker
DJ
.
Dipeptidyl peptidase-4 inhibition and the treatment of type 2 diabetes: preclinical biology and mechanisms of action
.
Diabetes Care
2007
;
30
:
1335
1343
[PubMed]
46.
Ahrén
B
.
Dipeptidyl peptidase-4 inhibitors: clinical data and clinical implications
.
Diabetes Care
2007
;
30
:
1344
1350
[PubMed]
47.
Boyle
JP
,
Honeycutt
AA
,
Narayan
KM
, et al
.
Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S
.
Diabetes Care
2001
;
24
:
1936
1940
[PubMed]
48.
Cook
CB
,
Ziemer
DC
,
El-Kebbi
IM
, et al
.
Diabetes in urban African-Americans. XVI. Overcoming clinical inertia improves glycemic control in patients with type 2 diabetes
.
Diabetes Care
1999
;
22
:
1494
1500
[PubMed]
49.
Lau
DT
,
Nau
DP
.
Oral antihyperglycemic medication nonadherence and subsequent hospitalization among individuals with type 2 diabetes
.
Diabetes Care
2004
;
27
:
2149
2153
[PubMed]
50.
Dray-Spira
R
,
Gary-Webb
TL
,
Brancati
FL
.
Educational disparities in mortality among adults with diabetes in the U.S
.
Diabetes Care
2010
;
33
:
1200
1205
[PubMed]
51.
Kim
C
,
Newton
KM
,
Knopp
RH
.
Gestational diabetes and the incidence of type 2 diabetes: a systematic review
.
Diabetes Care
2002
;
25
:
1862
1868
[PubMed]
52.
Lawrence
JM
,
Contreras
R
,
Chen
W
,
Sacks
DA
.
Trends in the prevalence of preexisting diabetes and gestational diabetes mellitus among a racially/ethnically diverse population of pregnant women, 1999-2005
.
Diabetes Care
2008
;
31
:
899
904
[PubMed]
53.
Fadini
GP
,
Baesso
I
,
Agostini
C
, et al
.
Maternal insulin therapy increases fetal endothelial progenitor cells during diabetic pregnancy
.
Diabetes Care
2008
;
31
:
808
810
[PubMed]
54.
Gross
JL
,
de Azevedo
MJ
,
Silveiro
SP
,
Canani
LH
,
Caramori
ML
,
Zelmanovitz
T
.
Diabetic nephropathy: diagnosis, prevention, and treatment
.
Diabetes Care
2005
;
28
:
164
176
[PubMed]
55.
Caravaggi
C
,
Faglia
E
,
De Giglio
R
, et al
.
Effectiveness and safety of a nonremovable fiberglass off-bearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study
.
Diabetes Care
2000
;
23
:
1746
1751
[PubMed]
56.
Blume
PA
,
Walters
J
,
Payne
W
,
Ayala
J
,
Lantis
J
.
Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial
.
Diabetes Care
2008
;
31
:
631
636
[PubMed]
57.
Goldstein
I
,
Young
JM
,
Fischer
J
,
Bangerter
K
,
Segerson
T
,
Taylor
T
;
Vardenafil Diabetes Study Group
.
Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes: a multicenter double-blind placebo-controlled fixed-dose study
.
Diabetes Care
2003
;
26
:
777
783
[PubMed]
58.
Atkinson
FS
,
Foster-Powell
K
,
Brand-Miller
JC
.
International tables of glycemic index and glycemic load values: 2008
.
Diabetes Care
2008
;
31
:
2281
2283
[PubMed]
59.
The Diabetes Prevention Program Research Group
.
The Diabetes Prevention Program: baseline characteristics of the randomized cohort
.
Diabetes Care
2000
;
23
:
1619
1629
[PubMed]
60.
Skyler
JS
,
Krischer
JP
,
Wolfsdorf
J
, et al
.
Effects of oral insulin in relatives of patients with type 1 diabetes: the Diabetes Prevention Trial—Type 1
.
Diabetes Care
2005
;
28
:
1068
1076
[PubMed]
61.
Plank
J
,
Bodenlenz
M
,
Sinner
F
, et al
.
A double-blind, randomized, dose-response study investigating the pharmacodynamic and pharmacokinetic properties of the long-acting insulin analog detemir
.
Diabetes Care
2005
;
28
:
1107
1112
[PubMed]
62.
International Expert Committee
.
International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes
.
Diabetes Care
2009
;
32
:
1327
1334
[PubMed]
63.
American Diabetes Association
.
Diagnosis and classification of diabetes mellitus
.
Diabetes Care
2010
;
33
(
Suppl. 1
):
S62
S69
[PubMed]
64.
Cefalu
WT
,
Kaul
S
,
Gerstein
HC
, et al
.
Cardiovascular outcomes trials in type 2 diabetes: where do we go from here? Reflections from a Diabetes Care Editors’ Expert Forum
.
Diabetes Care
2018
;
41
:
14
31
65.
Cefalu
WT
.
“TODAY” reflects on the changing “faces” of type 2 diabetes
.
Diabetes Care
2013
;
36
:
1732
1734
[PubMed]
66.
Malik
VS
,
Popkin
BM
,
Bray
GA
,
Després
JP
,
Willett
WC
,
Hu
FB
.
Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis
.
Diabetes Care
2010
;
33
:
2477
2483
[PubMed]
67.
Wing
RR
,
Lang
W
,
Wadden
TA
, et al.;
Look AHEAD Research Group
.
Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes
.
Diabetes Care
2011
;
34
:
1481
1486
[PubMed]
68.
de Mol
P
,
de Vries
ST
,
de Koning
EJ
,
Gans
RO
,
Bilo
HJ
,
Tack
CJ
.
Physical activity at altitude: challenges for people with diabetes: a review
.
Diabetes Care
2014
;
37
:
2404
2413
[PubMed]
69.
Barton
FB
,
Rickels
MR
,
Alejandro
R
, et al
.
Improvement in outcomes of clinical islet transplantation: 1999-2010
.
Diabetes Care
2012
;
35
:
1436
1445
[PubMed]
70.
Kovatchev
BP
,
Renard
E
,
Cobelli
C
, et al
.
Safety of outpatient closed-loop control: first randomized crossover trials of a wearable artificial pancreas
.
Diabetes Care
2014
;
37
:
1789
1796
[PubMed]
71.
Castle
JR
,
Engle
JM
,
El Youssef
J
, et al
.
Novel use of glucagon in a closed-loop system for prevention of hypoglycemia in type 1 diabetes
.
Diabetes Care
2010
;
33
:
1282
1287
[PubMed]
72.
Butler
PC
,
Elashoff
M
,
Elashoff
R
,
Gale
EA
. A critical analysis of the clinical use of incretin-based therapies: are the GLP-1 therapies safe? Diabetes Care
2013
;36:2118–2125
73.
Nauck
MA
.
A critical analysis of the clinical use of incretin-based therapies: the benefits by far outweigh the potential risks
.
Diabetes Care
2013
;
36
:
2126
2132
[PubMed]
74.
Harrison
LB
,
Adams-Huet
B
,
Raskin
P
,
Lingvay
I
.
β-Cell function preservation after 3.5 years of intensive diabetes therapy
.
Diabetes Care
2012
;
35
:
1406
1412
[PubMed]
75.
Buckingham
B
,
Beck
RW
,
Ruedy
KJ
, et al.;
Diabetes Research in Children Network (DirecNet) Study Group
;
Type 1 Diabetes TrialNet Study Group
.
Effectiveness of early intensive therapy on β-cell preservation in type 1 diabetes
.
Diabetes Care
2013
;
36
:
4030
4035
[PubMed]
76.
Gruden
G
,
Landi
A
,
Bruno
G
.
Natriuretic peptides, heart, and adipose tissue: new findings and future developments for diabetes research
.
Diabetes Care
2014
;
37
:
2899
2908
[PubMed]
77.
Pasquel
FJ
,
Umpierrez
GE
.
Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment
.
Diabetes Care
2014
;
37
:
3124
3131
[PubMed]
78.
Avogaro
A
,
Fadini
GP
.
The effects of dipeptidyl peptidase-4 inhibition on microvascular diabetes complications
.
Diabetes Care
2014
;
37
:
2884
2894
[PubMed]
79.
Riddle
MC
.
In an anniversary year, Diabetes Care takes a selfie
.
Diabetes Care
2018
;
41
:
3
5
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.