The Clinical and Integrative Diabetes and Obesity [CIDO] study section reviews clinical research (patient oriented research) applications related to carbohydrate, lipid, and energy metabolism in the setting of diabetes or obesity.  This study section also reviews translational research focused on the neuroendocrine regulation of all aspects of energy homeostasis involving CNS control of appetite and energy expenditure.  

Specific areas covered by CIDO:

• Pathogenesis of obesity and diabetes in humans: (1) regulation of glucose, fat, and protein metabolism; (2) homeostasis related to the pathogenesis of obesity and diabetes; (3) effects of dietary glucose, fat, and protein and their excesses on the production, secretion, and action of hormones (including insulin) and cytokines (including leptin) mediating energy and glucose homeostasis in diabetes
• Systemic actions of other hormones and cytokines (including leptin) when the central experimental focus is insulin action or energy homeostasis
• Energy expenditure, thermogenesis, physical activity, and exercise in the context of the pathogenesis or treatment of human obesity
• Body composition, the mechanisms which regulate it, and the metabolic consequences of distribution patterns of adipose tissue
• Functional consequences of skeletal muscle pathology relating to fuel metabolism, energy expenditure, accumulation of myocyte lipid, and possible secretory functions
• Central nervous system regulation of energy intake and expenditure and nutrient partitioning
• Neural mechanisms for sensing glucose and other nutrients
• Central nervous system effects and autonomic physiology related to energy metabolism on islet function and insulin action
• Hypoglycemia and counter regulatory mechanisms
• Prevention and treatment of obesity and diabetes 

CIDO has the following shared interests within the EMNR IRG:

·         With Molecular and Cellular Endocrinology [MCE]: Polypeptide hormone synthesis, secretion, and trafficking are areas of shared interest with MCE.  If the primary focus is islet or adipocyte hormone secretion, in the context of obesity or diabetes, applications could be referred to CADO, IPOD or CIDO.

·         With Integrative and Clinical Endocrinology and Reproduction [ICER] :  The study of the physiology of Polycystic Ovarian Syndrome (PCOS) are shared interests between ICER and CIDO.  When the application is focused on ovarian function assignment could be to ICER; applications that focus on insulin action and other aspects of relevant intermediary metabolism may be referred to IPOD or CIDO.

·         With Pregnancy and Neonatology [PN]: Applications may be referred to PN if they focus primarily on placental biology, complications of pregnancy, or immediate fetal or maternal outcomes. Applications focusing on carbohydrate metabolism, insulin secretion or long-term diabetes outcomes could be referred to either IPOD or CADO.

·         With Cellular Aspects of Diabetes and Obesity [CADO]:  Proposals in which the focus is on beta cell biology and/or physiology, insulin signaling and action, and adipocyte biology/physiology may be assigned to CADO.  Applications focusing on the actions of insulin and other hormones influencing energy homeostasis in the whole organism or integrating whole body insulin resistance and Polycystic Ovarian Syndrome (PCOS) in humans may be referred to CIDO.

·         With Integrative Nutrition and Metabolic Processes [INMP]: Applications focusing on lipoproteins and lipid metabolism may be referred to INMP.  Applications focusing on fuel (energy) regulation and the maintenance of homeostasis, the regulation of fuel (energy) flux between and storage in tissues and organs, and macronutrients related to energy metabolism and diabetes may be referred to IPOD.

·         With Integrative Physiology of Obesity and Diabetes [IPOD]:  CIDO and IPOD share conceptual and methodological interests.  Applications where the focus is patient oriented research may be assigned to CIDO.  Those which use animal models to explore the neuroendocrine regulation of energy homeostasis may be assigned to IPOD.  Applications which use animal, tissue or cell models related to diabetes or obesity may be assigned to IPOD.

CIDO has the following shared interests outside the EMNR IRG:

·         With the Genes, Genomes, and Genetics [GGG] IRG: Genetics of obesity and diabetes may be areas of shared interest with GGG.  Models of the complex genetic questions and mapping in animals or humans could be referred to GGG.  Analysis of the functional consequences of specific genetic alterations concerning obesity and/or diabetes could be referred to IPOD or CADO.  Genomic approaches to the molecular physiology of obesity and/or diabetes should be assigned in a manner consistent with the main focus of the application.  If genomic tools (e.g., DNA or protein microarrays, high throughput sequencing, SNP detection, bioinformatics) are used primarily to address questions regarding the physiology/pathogenesis of these states, the application could be referred to CADO, IPOD, or CIDO.  If a major focus is development of genomic techniques/materials for the study of these phenotypes, the application could be referred to GGG.

·         With the Biology of Development and Aging [BDA] IRG: There may be shared interests in the area of aging research.  Applications that focus on the pathogenesis or treatment of diabetes and obesity in the elderly may be referred to CADO, IPOD, or CIDO.  BDA may review applications with a primary emphasis on aging issues (i.e., on the role of aging changes or co-morbidity-related factors affecting pathogenesis of diabetes and obesity or responses to treatment in the elderly) when the study transcends a single organ system or discipline, or when the focus is on strategies to alter the rate of aging.  BDA could also review applications that focus on the effects of diabetes and obesity on pathophysiologic processes, clinical outcomes and functional status in the elderly when the study transcends a single organ system or discipline.

·         With the Bioengineering Sciences and Technologies [BST] IRG: Shared interest exists in the measurement of intracellular and physiological levels of glucose and other metabolites.  Applications that propose the development of new sensor technology are appropriate for BST; studies that use the instrumentation to monitor metabolite levels are appropriate for IPOD or CIDO.

·         With the Health of the Population [HOP] IRG: Applications that the focus on population- or community-based initiatives, e.g., education, provision of services, policy, and those that focus on socio-demographic variables could be assigned to HOP.  Studies related to epidemiology or large scale interventions for obesity or diabetes may generally be assigned to HOP.  Studies of diabetes and obesity involving the effects of human behavior on obesity, energy expenditure and food intake; studies of behavior modification directed toward the prevention or treatment of diabetes or obesity; or studies that focus on behavior as a risk factor for and as prevention of diabetes or obesity, or to moderate energy expenditure and food intake could be assigned to HOP.

·         With the Risk, Prevention and Health Behavior [RPHB] IRG: Shared interest exists regarding the metabolic regulation of obesity, diabetes, and insulin secretion and action.  Applications that utilize methodologies focusing on regulation at the cellular and molecular level could be assigned to CADO, IPOD, or CIDO.  Applications that focus on modification of individual behaviors, attitudes, psychosocial supports and resources as they affect prevention or treatment of obesity, diabetes, and insulin secretion and action could be assigned to RPHB.  Applications that focus on human behavior as a risk factor for and as prevention of obesity, or to moderate energy expenditure and food intake could be assigned to RPHB.

·         With the Oncological Sciences [ONC] IRG: Obesity or insulin resistance as a risk factor for cancer is an area of shared interest with ONC.  If the primary focus is oncogenesis, the application could be referred to ONC.  If the focus is fuel homeostasis, glucose homeostasis or insulin action on cell growth, it could be referred to CADO or IPOD.   Applications that explore the relationship between insulin/IGF signaling and cancer of endocrine or neuroendocrine tissues could be referred to CADO, IPOD or CIDO.

·         With the Cardiovascular Sciences [CVS] IRG: In general, applications that focus on the biology or pathogenesis of obesity could be referred to CADO, IPOD, or CIDO.  Applications that focus on the cardiovascular effects of obesity, e.g., left ventricular hypertrophy (LVH) or end stage arterial disease, may be referred to CVS.

·         With the Musculoskeletal, Oral, and Skin Sciences [MOSS] IRG: Exercise may be an area of shared interest with MOSS.  If the application deals primarily with the effects of exercise on the treatment, prevention, or consequences of obesity, diabetes, or insulin action, it could be referred to IPOD or CIDO.  Proposals that focus primarily upon glucose, lipid, and fuel metabolism in, or the effects of obesity, diabetes, or dietary changes on skeletal muscle, whole body, or multiple organ systems amay be appropriate for IPOD or CIDO.  Applications that primarily address the effects of exercise on skeletal muscle mass, function, or metabolism could be referred to MOSS.

·         With the Digestive Sciences [DIG] IRG: (1) The study of GI hormones may be an area of shared interest with DIG.  Applications that focus on gut-mediated effects on feeding, satiety, energy expenditure and islet hormone secretion could be referred to CIDO or CADO.  When the primary focus is hormones of the gastrointestinal tract or peptides and neurotransmitters of the brain-gut axis, applications could be assigned to DIG.  (2) There is also shared interest with cholesterol metabolism and complications of diabetes.  Applications dealing primarily with lipid metabolism in the liver as it relates to Non-Alcohol Fatty Liver Disease (NAFLD) could be assigned to DIG, and applications focused on lipoproteins, lipid metabolism, or diabetic complications could be assigned to IPOD or CIDO.

·         With the Respiratory Sciences [RES] IRG:  There is shared interest with areas related to obesity. Applications that have a focus on obesity in general, or on the genetics of obesity, but without a specific focus on sleep apnea or upper airway physiology, could be assigned to IPOD or CIDO. Similarly, applications that have a focus on metabolic syndrome in general, but without a major focus on obstructive sleep apnea, may be referred to IPOD or CIDO. Applications related to the impact of obesity on upper airway physiology (most notably, obstructive sleep apnea), on chest wall mechanics, or on asthma or other airways diseases could be assigned to RES.  Similarly, applications related to leptin in the context of control of breathing or obstructive sleep apnea could be assigned to RES.

·         With the Renal and Urological Sciences [RUS] IRG:  Applications that focus on the effects of nutrient metabolism in diabetic nephropathy and diabetes-induced metabolic abnormalities may be referred to  IPOD or CIDO.  RUS could be assigned applications on renal transport mechanisms intrinsic to diabetic nephropathy, diabetes-induced renal pathology, and diabetes-induced urologic pathology.

·         With the Integrative, Functional, and Cognitive Neuroscience [IFCN] IRG:  Studies of the central nervous system that focus on metabolic homeostasis or causes of obesity are of shared interest with IFCN.  These could be referred to CADO or CIDO when end points relate primarily to cellular or systemic metabolic phenotypes or energy balance and to IFCN when the focus is on the neural basis of ingestive behaviors or satiety. 

·         With the Molecular, Cellular, and Developmental Neuroscience [MDCN] IRG: Cellular and molecular studies that focus on diabetic neuropathy may be referred to MDCN; studies that focus on diabetes may be referred to CADO, IPOD or CIDO.

·         With the Brain Disorders and Clinical Neuroscience [BDCN] IRG: Physiological or clinical studies that focus on diabetic neuropathy or diabetes-induced abnormalities may be referred to BDCN; studies that focus on diabetes may be referred to CADO or CIDO.