Welcome to University of Iowa Health Care Today. Recently, The University of Iowa and UI Foundation announced a $25 million gift from The Fraternal Order of Eagles to be used for diabetic research. Dr. John Stokes joins me now by phone to tell us about this enormous gift to the university and what it will do for diabetic research. Dr. Stokes is a professor and director of the nephrology division with University of Iowa Health Care. Not only does Dr. Stokes specialize in treating and studying diabetes, he is also a member of The Fraternal Order of Eagles. Dr. Stokes,

What is diabetes?

Diabetes, as most Americans know, is a condition where an individual’s blood sugar (blood glucose) is elevated, often substantially above the normal range. And in general, there are two different types of diabetes: one which generally affects younger people, children, young adults—that’s type one, where these people have a lack of insulin; they don’t make enough insulin in their pancreas. Usually the reason for this is the cells that make insulin have been destroyed. An even bigger problem—from the public health perspective—is the adult form of diabetes, or type two, where people, as they get older, make insulin, and sometimes make a lot of insulin, but the insulin doesn’t work properly. It doesn’t cause the appropriate lowering of the blood sugar as it does in otherwise normal people. So this elevation, this constant elevation of blood sugar or blood glucose over a long period of time has devastating effects on almost every organ. Every blood vessel reacts badly to having these high levels of blood sugar.

How many people in America are affected by diabetes?

We estimate about 20 million Americans have diabetes; probably 10 or 15 percent, maybe more, don’t even know it—they’re the people that have the adult form—because diabetes can be a silent disease, in other words, the symptoms can be pretty minimal; sometimes there’s just tiredness, but sometimes there’s absolutely no symptoms whatsoever, and the disease creates havoc and destroys organs and blood vessels even though nobody knows about it.

Is there a certain age, gender, or race more likely to be affected by diabetes?

Yes, men and women are affected about the same. Older people are at higher risk for developing the type two or the adult form of diabetes. People who are overweight also are at higher risk. And there are some populations within this country that are at higher risk. The most notable are Native Americans—American Indians, so to speak—and the reasons for this are probably genetic, but we don’t understand all the details.

Is diabetes costly to treat each year, not just individually but as a nation?

Yes, it is. The cost of diabetes is extraordinary. We’ve just gone through and reviewed the data on this. It costs the country one hundred and seventy-four billion dollars a year (that was last year) for diabetes treatment, lost work, and lost productivity. That’s an enormous amount of money. And I also will just put this into context. I’m a nephrologist—a kidney specialist, and it turns out that one-tenth of all the expenditures for Medicare go to treat kidney disease/dialysis, and half of all the people on dialysis are there because they have diabetes. So it’s a very, very expensive disease.

Is there currently a cure for diabetes?

There are no cures now for diabetes. There are treatments, to be sure; that’s different than a cure. When insulin was discovered many, many years ago, that was a brilliant step and certainly saved the lives of hundreds of thousands of insulin-dependent, juvenile-type diabetics. Many, many diabetics have to take insulin; it’s just a treatment. There are other kinds of medicines that are used to treat diabetes, but one of the things that we all recognize is that our treatment programs really are not as good as we would hope they should be. We don’t have a cure for it, and we don’t have ways yet that are solid ways that we can prevent diabetes—these are all areas that need a lot of attention, a lot of work.

Who belongs to The Fraternal Order of Eagles? What is their mission?

The Fraternal Order of Eagles is a group in the United States and Canada, so it’s a North American fraternal organization whose major purpose is to raise money to help alleviate the suffering of mankind; and that’s, of course, a noble, noble mission. They focus mostly on helping to cure health problems and they focus a lot of their fundraising efforts to fund research projects, so I got to know the Eagles when I came to Iowa 30 years ago, because they have small grants they give for kidney research. And I’ve applied for these grants and received many on many occasions throughout the years and was so intrigued by the organization; so taken by what they are doing and how they go about doing it, that I joined, because I’m a very strong supporter of this kind of activity. They’re wonderful people. They’re generous and they really want to help people. Their motto is “People helping people.”

Tell us about the gift from the Eagles. How will this large donation be used to advance diabetes research at The University of Iowa?

This gift will fund a new research center. It will be called The Fraternal Order of Eagles Diabetes Research Center at The University of Iowa, and it will be placed physically within a new building that The University of Iowa is building. It’s called the Institute for Biomedical Discovery and the idea of this building is to bring together scientists, investigators, and creative people who can attack real problems, real health problems such as diabetes, from different perspectives and put together teams of people. This is a wonderful example of how a center such as the Eagles have caused to be formed because of their gift, will fit into the overall plan for The University of Iowa to help people and solve difficult medical problems.

Will the $25 million donation be a one-time donation or be delivered over several years?

It will be spread out. Last week the Eagles made a pledge; they made the commitment. And by the way, I was at the national convention when they made this and it was an absolute unanimous vote to fund this, and the idea would be to raise five million dollars per year for the next five years and all of that money will go to the Eagles Diabetes Research Center. And all of that money will be used for research programs. The University of Iowa would commit to building the building and the maintenance of the building itself.

In return, how will the Eagles be recognized for their contribution to The University of Iowa?

We imagine that the Eagles will get lots of recognition along the way. The Center will be named for the Eagles and we’re in the process of developing other ways that individual Eagles might be recognized, and different groups of Eagles can be recognized for their contributions, too.

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John Stokes, M.D.

Fraternal Order of Eagles