Findings

Congress makes the following findings: (1)According to the Centers for Disease Control and Prevention, the prevalence of diabetes in the United States has more than doubled in the past quarter-century. (2)The American Diabetes Association reports that there are now more than 20,000,000 people in the United States living with diabetes, with 6,000,000 of these cases not yet diagnosed. Another 54,000,000 people in the United States have pre-diabetes, which means that they have higher than normal blood glucose levels, and are at increased risk of developing diabetes. (3)In 2002, the landmark Diabetes Prevention Program study found that lifestyle changes, such as diet and exercise, can prevent or delay the onset of type 2 diabetes, and that participants who made such lifestyle changes reduced their risk of getting type 2 diabetes by 58 percent. (4)The New York Times has reported that lifestyle-based interventions to control diabetes have resulted in positive outcomes for patients, yet despite these successes, such interventions were often unsustainable. While insurance companies cover the treatments of complications of unchecked diabetes, they tend not to cover the cheaper interventions to prevent such complications. (5)According to the American Diabetes Association, in 2002, direct medical expenditures for diabetes totaled $91,800,000,000, including $23,200,000,000 for diabetes care, and $24,600,000,000 for chronic complications attributable to diabetes. In that year, approximately 1 out of every 10 health care dollars was directed to diabetes. (6)There is a need to increase the availability of effective community-based lifestyle programs for diabetes prevention and the ability of health care providers to refer patients for enrollment in such programs to prevent diabetes, reduce complications, and lower the costs associated with diabetes treatment in the United States, and the Federal government should encourage efforts to replicate the results of the Diabetes Prevention Program on a wider scale.

Centers for Disease Control and Prevention Division of Diabetes Translation; diabetes demonstration projects

Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by inserting after section 317S the following:

317T.

Centers for Disease Control and Prevention Division of Diabetes Translation

(a)

In general

The Director of the Centers for Disease Control and Prevention shall establish within such Centers a Division of Diabetes Translation to eliminate the preventable burden of diabetes. (b)

Office

The Division of Diabetes Translation shall carry out the following activities: (1)Supporting and carrying out diabetes surveillance. (2)Conducting applied translational research, including research that will improve early detection, prevention, and access to quality care with respect to diabetes. (3)Working with States to establish and improve diabetes control and prevention programs. (4)Coordinating the National Diabetes Education Program in conjunction with the National Institutes of Health. (5)Increasing education and awareness of diabetes. (6)Promoting greater awareness of the health effects of uncontrolled diabetes. (7)Other activities as deemed appropriate by the Director. (c)

Appropriations

There are authorized to be appropriated to carry out the activities of the Division of Diabetes Translation under this section $90,000,000 for fiscal year 2008, and such sums as may be necessary for each subsequent fiscal year.

317U.

Demonstration projects for the identification and treatment for persons diagnosed with or at high risk for diabetes

(a)

Identification and prevention demonstration projects for persons at high risk for type 2 diabetes

(1)

In general

(A)

Development

The Director of the Centers for Disease Control and Prevention (referred to in this section as the Director), in consultation with the Division of Diabetes Translation and academic centers, shall develop a set of pilot demonstration projects to evaluate various approaches to— (i)screening and identifying persons with pre-diabetes and undiagnosed diabetes; and (ii)providing identified persons with access to appropriate lifestyle interventions. (B)

Linkage to diabetes prevention program

Such pilot projects shall be carried out with the goal of translating, using lifestyle interventions available in the community, the Diabetes Prevention Program clinical trial into interventions to reduce the incidence of type 2 diabetes and its related complications in the United States population. (2)

Cooperative agreements

(A)

In general

The Director shall provide cooperative agreements and technical assistance to not more than 10 academic centers partnered with State or local public health departments to implement, monitor, and evaluate such pilot projects. (B)

Application

Applicants shall submit to the Director an application, at such time, in such manner, and containing such information as the Director may require, including— (i)information documenting the risk of the populations to be targeted by this intervention; and (ii)information regarding the methods that shall be used to identify and screen these populations. (3)

Duration

The cooperative agreements awarded under this subsection shall be awarded for a 2-year period, with the Director having the option to extend cooperative agreements for an additional 2-year period. (4)

Evaluation

Not later than 4 years after the date of the enactment of the Diabetes Treatment and Prevention Act of 2007, the Director shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report evaluating the effectiveness of the program under this subsection and shall make such report publicly available. (5)

Authorization of appropriations

There are authorized to be appropriated $10,000,000 to carry out this subsection for each of fiscal years 2008 through 2012. (b)

State partnerships for surveillance and education

(1)

In general

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall engage in partnerships with State and local health departments to carry out the following activities: (A)National, State, and local (to the degree determined by the Secretary) surveillance of the following items: (i)The number of individuals and percentage of the population at risk for developing diabetes. (ii)The number of individuals and percentage of the population who have received diabetes and high blood glucose screenings. (iii)Among those individuals who have been identified with pre-diabetes, the proportion that have been enrolled into lifestyle programs. (iv)The availability of interventions to prevent diabetes, and the access of the population to such interventions. (v)The number of individuals and percentage of population with both newly-diagnosed cases of diabetes and existing cases of diabetes, as well as the rates of increase or decrease in newly-diagnosed diabetes. (vi)Other relevant factors as determined by the Secretary. (B)Education and information campaigns to increase awareness among populations at high risk for diabetes, health care providers, and the general public, about the importance of primary prevention, ways to assess personal risk, and how to locate and access diabetes prevention programs. (2)

Authorization of appropriations

There are authorized to be appropriated $10,000,000 to carry out this subsection for each of the fiscal years 2008 through 2012. (c)

Treatment demonstration projects for co-occurring chronic conditions

(1)

In general

The Director, acting through the Division of Diabetes Translation, shall develop a pilot program to improve treatment for individuals with diabetes and other co-occurring chronic conditions, such as mental illness, high blood pressure, or cardiovascular disease, for which treatment may complicate the treatment for diabetes. (2)

Cooperative agreements

(A)

In general

The Director shall provide cooperative agreements and technical assistance to not more than 10 academic centers, in partnership with State and local health departments, to implement, monitor, and evaluate programs designed to improve health outcomes in individuals with diabetes and other co-occurring chronic conditions. (B)

Application

Applicants shall submit to the Director an application, at such time, in such manner, and containing such information as the Director may require, including information regarding the co-occurring conditions that shall be the subject of study. (C)

Preference

In awarding the cooperative agreements under this subsection, the Director shall give preference for research that focuses on conditions which have a high prevalence among individuals with diabetes, or for which the treatment involved has the potential to impact adherence to diabetes treatment regimens and that builds upon existing work designed to improve the quality of care for patients with diabetes. (3)

Duration

Evaluation

Appropriations

There are authorized to be appropriated $10,000,000 to carry out this subsection for each of the fiscal years 2008 through 2012.