1.This Act may be cited as
the Gestational Diabetes Act of
2007
or the GEDI Act
.
2.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 increases the risk of 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.
3.The Public Health
Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the
following:
<enum>XXX</enum><header>Gestational
Diabetes</header>
<section id="id3B6482C055DC4CD7BF45867E1B7ECEC2"><enum>3001.</enum><header>Understanding
and Monitoring Gestational Diabetes and Obesity During Pregnancy</header>
<subsection id="id56DA207C76E046479FD0C42547640140"><enum>(a)</enum><header>In
general</header><text>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.</text>
</subsection><subsection id="id20F7B7B08C864BD085F36EBA1DC93A9F"><enum>(b)</enum><header>Membership</header><text>Membership
in the Research Advisory Committee—</text>
<paragraph id="id4DC58335AD0E4C2EB59B489C9773133D"><enum>(1)</enum><text>shall
include—</text>
<subparagraph id="id8127CFA118614137A8BC32280E8865D3"><enum>(A)</enum><text>a representative
from the Agency for Healthcare Research and Quality;</text>
</subparagraph><subparagraph id="idF830DB9737B64D8C982251CD078A2C8B"><enum>(B)</enum><text>a representative
from the Centers for Disease Control and Prevention;</text>
</subparagraph><subparagraph id="id61CF8A4CCF7F41B78183ADEE96C62259"><enum>(C)</enum><text>a representative
from the National Institutes of Health;</text>
</subparagraph><subparagraph id="id896E16CB4B4F4D55BFB207EC3DC3A551"><enum>(D)</enum><text>a representative
from the Office of Minority Health;</text>
</subparagraph><subparagraph id="idAFA9ABC0DB014C9AA53DC15A8A0EF845"><enum>(E)</enum><text>a representative
from the Indian Health Service; and</text>
</subparagraph><subparagraph id="id73374C3260E4499DA48B7148E8B122BF"><enum>(F)</enum><text>representatives
from other appropriate Federal agencies; and</text>
</subparagraph></paragraph><paragraph id="id2EF9A34447984076860B0F5478B184E6"><enum>(2)</enum><text>may include
representatives from other appropriate organizations.</text>
</paragraph></subsection><subsection id="idB0E252D9142A489F83943944B7A2CC0A"><enum>(c)</enum><header>Matters To Be
Studied</header><text>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—</text>
<paragraph id="id16D30E05083E480F9D4BA95053BB2C1A"><enum>(1)</enum><text>the use of
consistent standards to measure gestational diabetes;</text>
</paragraph><paragraph id="idACF77086787A4AC894BF2963F5C214A5"><enum>(2)</enum><text>the procedures to
establish accurate and efficient systems for the collection of gestational
diabetes data within each State;</text>
</paragraph><paragraph id="id925397045F0041A7A6FB2BDC92E96614"><enum>(3)</enum><text>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;</text>
</paragraph><paragraph id="id9E28D4CE651440B795E2FD2184BB697F"><enum>(4)</enum><text>the establishment
of procedures for reporting gestational diabetes data to the Centers for
Disease Control and Prevention;</text>
</paragraph><paragraph id="id2A660991CC654C42A2A0EF9FB93C79D3"><enum>(5)</enum><text>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;</text>
</paragraph><paragraph id="id5A138B499745433A85362EDF17DF5D61"><enum>(6)</enum><text>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</text>
</paragraph><paragraph id="idB1C42A1FA1524C91A528E7F50C4EF58D"><enum>(7)</enum><text>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.</text>
</paragraph></subsection><subsection id="idEAF45FDAEDF94607B54E108BA381E1EA"><enum>(d)</enum><header>Meetings</header><text>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.</text>
</subsection><subsection id="id81236CBB557A4799BA8332486712D098"><enum>(e)</enum><header>Report</header><text>Not
later than 2 years after the date of enactment of the
<short-title>Gestational Diabetes Act of
2007</short-title>, 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.</text>
</subsection></section><section id="idC5425FB9EFE44B0081E1D8E7BA6AB7D5"><enum>3002.</enum><header>Demonstration
Grants to lower the rate of Gestational Diabetes and Obesity during
Pregnancy</header>
<subsection id="id9CF5C571D2DA45649FDF12668977598E"><enum>(a)</enum><header>In
general</header><text>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
3001, 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—</text>
<paragraph id="id942B2D7370F64F20BF21B6B4333E5383"><enum>(1)</enum><text>the prevention or
delay of type 2 diabetes is possible for older adults;</text>
</paragraph><paragraph id="id9190115464B54F7484385CC938B7A0D9"><enum>(2)</enum><text>the diabetes risk
status of an individual is likely established during the individual's earlier
age (adolescence through the age of 30);</text>
</paragraph><paragraph id="idCD599A2EE8294A62AB2D0A0FF2CF51AA"><enum>(3)</enum><text>women are
uniquely capable of demonstrating their diabetes risk status, through acquiring
gestational diabetes during the challenge of pregnancy;</text>
</paragraph><paragraph id="id09F1BF3C7A8D4DEE8D79A7D35E743078"><enum>(4)</enum><text>gestational
diabetes itself is a well-established risk factor for a woman's subsequent
transition to type 2 diabetes; and</text>
</paragraph><paragraph id="id9718280E46744125944C795C3A548A57"><enum>(5)</enum><text>gestational
diabetes may confer risks of future obesity and type 2 diabetes on the children
of a mother with gestational diabetes.</text>
</paragraph></subsection><subsection id="id78FD7E5EE9EC4D9CA4ED19CDB430CE5A"><enum>(b)</enum><header>Application</header><text>An
eligible entity desiring to receive a grant under this section shall submit to
the Director of the Centers for Disease Control and Prevention—</text>
<paragraph id="id9FF74C94432045928FB166759D9258B2"><enum>(1)</enum><text>an application at
such time, in such manner, and containing such information as the Director may
require; and</text>
</paragraph><paragraph id="idFA669BAB85624F48B960BB453C934AC9"><enum>(2)</enum><text>a plan to—</text>
<subparagraph id="id6FAB428EB2E2415BBB2758481247F5CD"><enum>(A)</enum><text>lower the rate of
gestational diabetes and obesity during pregnancy; or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id7623266C52784DEDA91FA0CF234F6510"><enum>(B)</enum><text>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.</text>
</subparagraph></paragraph></subsection><subsection id="id4202CCB137EF4C4A896201745DC57B80"><enum>(c)</enum><header>Uses of
funds</header><text>An entity receiving a grant under this section shall use
grant funds to carry out demonstration projects, which may include—</text>
<paragraph id="IDa52327f679514321b5a407e83537214e"><enum>(1)</enum><text>expanding
community-based health promotion education, activities, and incentives focused
on the prevention of gestational diabetes and obesity during pregnancy;</text>
</paragraph><paragraph id="ID5ec1328eb54b4f388c642383a2f78492"><enum>(2)</enum><text>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;</text>
</paragraph><paragraph id="ID07767936a5404b4894029793025d5544"><enum>(3)</enum><text>building capacity
with State-based partners to implement programs and interventions based on
surveillance data; and</text>
</paragraph><paragraph id="ID9349e8edecf3460b95811d3b44ead914"><enum>(4)</enum><text>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.</text>
</paragraph></subsection><subsection id="id01B10BE244FB4C6A9D05FF3369FC5DE0"><enum>(d)</enum><header>Reports</header>
<paragraph id="id1D9084853C9A43359E04DC89B91F330D"><enum>(1)</enum><header>CDC
report</header><text display-inline="yes-display-inline">Not later than 2 years
after the date of enactment of the <short-title>Gestational Diabetes Act of 2007</short-title>, 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.</text>
</paragraph><paragraph id="idED59EABF51074514A1CEE3AD4882AA65"><enum>(2)</enum><header>Secretary
report</header><text>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.</text>
</paragraph></subsection><subsection id="id5BAC8B2069C044BD868206E979FEAFDD"><enum>(e)</enum><header>Definition of
eligible entity</header><text>In this section, the term <term>eligible
entity</term> means a nonprofit organization (such as an academic center or
community health center) or a State health agency.</text>
</subsection><subsection id="id509D2BE61D234E58B0C58B16D60F1161"><enum>(f)</enum><header>Authorization
of appropriations</header><text>There are authorized to be appropriated to
carry out this section $5,000,000 for fiscal year 2008 and such sums as may be
necessary for each of the fiscal years 2009 through 2012.</text>
</subsection></section><section id="id221B8F8C450642909DB0A1E8E68392BA"><enum>3003.</enum><header>Research
Expansion of Gestational Diabetes and Obesity during Pregnancy</header>
<subsection id="id2D8377E3986443F6BB2F502A0F16AA6B"><enum>(a)</enum><header>In
general</header><text>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—</text>
<paragraph id="id6B656195F9594E728B666EB9623AA099"><enum>(1)</enum><text>investigating
therapies, interventions, and agents to detect, treat, and slow the incidence
of, gestational diabetes and obesity during pregnancy;</text>
</paragraph><paragraph id="id75932E40D643459FA7205746195DF30C"><enum>(2)</enum><text>developing and
testing novel approaches to the design and analysis of clinical trials;</text>
</paragraph><paragraph id="idB9398E003C8D4A12B4B02816C4874B00"><enum>(3)</enum><text>facilitating the
enrollment of patients for clinical trials, including patients from diverse
populations and populations who suffer disproportionately from these
conditions;</text>
</paragraph><paragraph id="idBB807005584A4ABFB3C7D67DAD3A1C6A"><enum>(4)</enum><text>developing
improved diagnostics and means of patient assessment for gestational diabetes
and obesity during pregnancy; and</text>
</paragraph><paragraph id="id83D75CD8CF41465784F3C461BCCF3D21"><enum>(5)</enum><text>conducting public
health research to further knowledge on epidemiologic, socioenvironmental,
behavioral, translation, and biomedical factors that influence gestational
diabetes and obesity during pregnancy.</text>
</paragraph></subsection><subsection id="id8A67FF16C9D0493096D7C1440C2FFB2D"><enum>(b)</enum><header>Authorization
of appropriations</header><text>There are authorized to be appropriated to
carry out this section $8,000,000 for fiscal year 2008 and such sums as may be
necessary for each of the fiscal years 2009 through 2012.</text>
</subsection></section><section id="id68E09DB7EDA34A82B552A498CADD92E1"><enum>3004.</enum><header>Screening for
gestational diabetes</header><text display-inline="no-display-inline">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.</text>
</section>.