[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3914 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 3914

To establish an Advisory Committee on Gestational Diabetes, to provide 
 grants to better understand and reduce gestational diabetes, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 20, 2006

 Mrs. Clinton (for herself, Ms. Collins, and Mrs. Lincoln) introduced 
the following bill; which was read twice and referred to the Committee 
               on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To establish an Advisory Committee on Gestational Diabetes, to provide 
 grants to better understand and reduce gestational diabetes, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Gestational Diabetes Act of 2006'' 
or the ``GEDI Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The prevalence of gestational diabetes among pregnant 
        women in the United States is increasing.
            (2) Gestational diabetes, which is similar to chronic forms 
        of diabetes, normally appears at 24 to 28 weeks' gestation and 
        occurs in approximately 4 to 8 percent of pregnant women.
            (3) The causes of gestational diabetes are unknown, but 
        genetics, excess weight, ethnicity, and age are considered risk 
        factors for the condition.
            (4) There is disagreement among physicians about how to 
        treat gestational diabetes, as well as the effectiveness of 
        current treatment regimens.
            (5) Gestational diabetes, which can cause preeclampsia, 
        also increases a pregnant woman's risk for developing the 
        condition in subsequent pregnancies.
            (6) Infants of women who develop gestational diabetes may 
        have extreme increases in birth weight and the risks related to 
        difficulties during the birthing process, and some of the 
        infants born to these women--
                    (A) may subsequently have low blood sugar or 
                jaundice during the newborn period;
                    (B) are at an increased risk for obesity and birth 
                trauma; and
                    (C) are at an increased risk of developing type 2 
                diabetes as an adolescent or adult.
            (7) About 15 percent of infertility cases are linked to 
        weight disorders, most often being overweight or obese. Obesity 
        affects fertility and is also associated with increased 
        morbidity for both the mother and the child.
            (8) Improved nutritional and physical health care, both 
        before and during pregnancy, may significantly decrease the 
        rates of gestational diabetes.
            (9) Ten percent of obese pregnant women are estimated to 
        have gestational diabetes.
            (10) Obesity potentially leads to a higher rate of 
        induction and primary caesarean section.

SEC. 3. GESTATIONAL DIABETES.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

                   ``TITLE XXIX--GESTATIONAL DIABETES

``SEC. 2901. UNDERSTANDING AND MONITORING GESTATIONAL DIABETES AND 
              OBESITY DURING PREGNANCY.

    ``(a) In General.--The Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease Control and 
Prevention, shall convene a Research Advisory Committee.
    ``(b) Membership.--Membership in the Research Advisory Committee--
            ``(1) shall include--
                    ``(A) a representative from the Agency for 
                Healthcare Research and Quality;
                    ``(B) a representative from the Centers for Disease 
                Control and Prevention;
                    ``(C) a representative from the National Institutes 
                of Health;
                    ``(D) a representative from the Office of Minority 
                Health;
                    ``(E) a representative from the Indian Health 
                Service; and
                    ``(F) representatives from other appropriate 
                Federal agencies; and
            ``(2) may include representatives from other appropriate 
        organizations.
    ``(c) Matters To Be Studied.--The Director of the Centers for 
Disease Control and Prevention, in consultation with the Research 
Advisory Committee, shall develop a multisite, gestational diabetes 
research project within the diabetes program of the Centers for Disease 
Control and Prevention to expand and enhance surveillance data and 
public health research on gestational diabetes. The project shall 
address--
            ``(1) the use of consistent standards to measure 
        gestational diabetes;
            ``(2) the procedures to establish accurate and efficient 
        systems for the collection of gestational diabetes data within 
        each State;
            ``(3) the progress of collaborative activities with the 
        National Vital Statistics System, the National Center for 
        Health Statistics, and State health departments with respect to 
        the standard birth certificate, in order to improve 
        surveillance of gestational diabetes;
            ``(4) the establishment of procedures for reporting 
        gestational diabetes data to the Centers for Disease Control 
        and Prevention;
            ``(5) post-natal methods of tracking women who had 
        gestational diabetes after delivery and the development of ways 
        to lower the incidence of type 2 diabetes in that population;
            ``(6) variations in the distribution of diagnosed and 
        undiagnosed diabetes and of impaired fasting glucose tolerance 
        and impaired fasting glucose within and among groups of women; 
        and
            ``(7) factors that influence risks for gestational diabetes 
        and obesity during pregnancy and complications during 
        childbirth among women, including cultural, racial, ethnic, 
        geographic, demographic, socioeconomic, and genetic factors.
    ``(d) Meetings.--Not later than 1 year after the establishment of 
the gestational diabetes research project under subsection (c), and 
annually thereafter, the Research Advisory Committee shall meet to 
assess the progress of the project and to update the Secretary of 
Health and Human Services, if necessary.
    ``(e) Report.--Not later than 2 years after the date of enactment 
of the Gestational Diabetes Act of 2006, and annually thereafter, the 
Director of the Centers for Disease Control and Prevention shall 
generate a report on the prevalence of gestational diabetes and 
disseminate the report to the Secretary of Health and Human Services 
and appropriate Federal and non-Federal agencies.

``SEC. 2902. DEMONSTRATION GRANTS TO LOWER THE RATE OF GESTATIONAL 
              DIABETES AND OBESITY DURING PREGNANCY.

    ``(a) In General.--The Secretary of Health and Human Services, 
acting through the Director of the Centers for Disease Control and 
Prevention, in consultation with the Research Advisory Committee 
established under section 2901, shall award grants, on a competitive 
basis, to eligible entities for demonstration projects that test 
specified hypotheses about interventions designed to reduce the 
incidence of gestational diabetes and obesity among young women and 
implement relevant activities. In making such grants, the Director 
shall act on scientific findings that--
            ``(1) the prevention or delay of type 2 diabetes is 
        possible for older adults;
            ``(2) the diabetes risk status of an individual is likely 
        established during the individual's earlier age (adolescence 
        through the age of 30);
            ``(3) women are uniquely capable of demonstrating their 
        diabetes risk status, through acquiring gestational diabetes 
        during the challenge of pregnancy;
            ``(4) gestational diabetes itself is a well-established 
        risk factor for a woman's subsequent transition to type 2 
        diabetes; and
            ``(5) gestational diabetes may confer risks of future 
        obesity and type 2 diabetes on the children of a mother with 
        gestational diabetes.
    ``(b) Application.--An eligible entity desiring to receive a grant 
under this section shall submit to the Director of the Centers for 
Disease Control and Prevention--
            ``(1) an application at such time, in such manner, and 
        containing such information as the Director may require; and
            ``(2) a plan to--
                    ``(A) lower the rate of gestational diabetes and 
                obesity during pregnancy; or
                    ``(B) conduct post-natal methods of tracking women 
                who had gestational diabetes in order to develop ways 
                to lower the incidence of such mothers developing type 
                2 diabetes.
    ``(c) Uses of Funds.--An entity receiving a grant under this 
section shall use grant funds to carry out demonstration projects, 
which may include--
            ``(1) expanding community-based health promotion education, 
        activities, and incentives focused on the prevention of 
        gestational diabetes and obesity during pregnancy;
            ``(2) aiding State-based diabetes prevention and control 
        programs to collect, analyze, disseminate, and report 
        surveillance data on women with, and at risk for, gestational 
        diabetes and obesity during pregnancy;
            ``(3) building capacity with State-based partners to 
        implement programs and interventions based on surveillance 
        data; and
            ``(4) training and encouraging health care providers to 
        promote risk assessment, quality care, and self-management for 
        gestational diabetes and obesity during pregnancy and its 
        complications in the practice settings of the health care 
        providers.
    ``(d) Reports.--
            ``(1) CDC report.--Not later than 2 years after the date of 
        enactment of the Gestational Diabetes Act of 2006, the Director 
        of the Centers for Disease Control and Prevention shall prepare 
        and submit a report to the Secretary of Health and Human 
        Services concerning the results of the studies conducted 
        through the grants awarded under this section.
            ``(2) Secretary report.--Not later than 90 days after 
        receiving the report described in paragraph (1), the Secretary 
        shall prepare and submit a report to Congress concerning the 
        results and findings of the report.
    ``(e) Definition of Eligible Entity.--In this section, the term 
`eligible entity' means a nonprofit organization (such as an academic 
center or community health center) or a State health agency.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2007 
and such sums as may be necessary for each of the fiscal years 2008 
through 2011.

``SEC. 2903. RESEARCH EXPANSION OF GESTATIONAL DIABETES AND OBESITY 
              DURING PREGNANCY.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention and the Director of the National Institute of Child 
Health and Human Development, in collaboration with the National 
Institute of Diabetes and Digestive and Kidney Diseases, shall conduct 
and support basic, clinical, and public health research regarding 
gestational diabetes and obesity during pregnancy. Such research shall 
include--
            ``(1) investigating therapies, interventions, and agents to 
        detect, treat, and slow the incidence of, gestational diabetes 
        and obesity during pregnancy;
            ``(2) developing and testing novel approaches to the design 
        and analysis of clinical trials;
            ``(3) facilitating the enrollment of patients for clinical 
        trials, including patients from diverse populations and 
        populations who suffer disproportionately from these 
        conditions;
            ``(4) developing improved diagnostics and means of patient 
        assessment for gestational diabetes and obesity during 
        pregnancy; and
            ``(5) conducting public health research to further 
        knowledge on epidemiologic, socioenvironmental, behavioral, 
        translation, and biomedical factors that influence gestational 
        diabetes and obesity during pregnancy.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $8,000,000 for fiscal year 2007 
and such sums as may be necessary for each of the fiscal years 2008 
through 2011.

``SEC. 2904. SCREENING FOR GESTATIONAL DIABETES.

    ``The Director of the Centers for Disease Control and Prevention 
shall encourage screening for gestational diabetes within the State-
based diabetes prevention and control programs assisted by the Centers 
for Disease Control and Prevention, for the purpose of reducing the 
incidence of gestational diabetes and its related complications.''.
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