[Congressional Record Volume 152, Number 118 (Wednesday, September 20, 2006)]
[Senate]
[Pages S9788-S9791]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. CLINTON (for herself, Ms. Collins, and Mrs. Lincoln):
  S. 3914. A bill to establish an Advisory Committee on Gestational 
Diabetes, to provide grants to better understand and reduce gestational 
diabetes, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, I am pleased to introduce the 
Gestational Diabetes Act of 2006 to bring attention to an important 
health issue facing women and children.
  I don't need to tell anyone that we have an obesity epidemic in the 
United States. Too many in our country don't know that eating poorly 
and not taking care of themselves can have significant health impacts. 
For women, these health issues can become especially significant during 
pregnancy.
  Women who are overweight or obese are more likely to have a C-section 
and are at an increased risk for serious complications with their 
pregnancy. And more women then ever are entering their pregnancies 
overweight which can also trigger gestational diabetes.
  In New York, gestational diabetes has risen by nearly 50 percent in 
about 10 years. In New York City alone, gestational diabetes affects 1 
in 25 women, about 400 women per month. Gestational diabetes affects 
between 4 and 8 percent of pregnant women in the United States. Infants 
of women who have gestational diabetes are at increased risk for 
obesity and developing Type 2 diabetes as adolescents or adults.
  As women we need to pay attention to our health. We are always 
worrying about the health of our children, our husbands, and our 
parents. But we often forget to take care of ourselves.
  Prevention is critical and I applaud new initiatives from the New 
York City Department of Health to increase efforts to inform women 
about gestational diabetes and behaviors that can prevent Type 2 
Diabetes.
  Today, I am introducing the Gestational Diabetes Act, also known as 
the GEDI Act. This legislation will increase our understanding by 
determining the factors that contribute to this condition and help 
mothers who had gestational diabetes reduce their risk of developing 
Type 2 diabetes.
  This Act will provide funding for projects to assist health care 
providers and communities find ways to reach out to women so that they 
understand how their health during pregnancy will impact not only their 
child's health, but also their own.
  The GEDI Act would expand research to determine and develop 
interventions that will lower the incidence of gestational diabetes. We 
need to alert women to the risk before this condition becomes an 
epidemic.
  We should be doing everything we can to address the growing 
prevalence of gestational diabetes and obesity during pregnancy. The 
GEDI Act is an important step in assuring that women understand this 
critical issue.
  The GEDI Act is supported by: American Association of Colleges of 
Pharmacy, American Association of Diabetes Educators, American Diabetes 
Association, American Dietetic Association, American College of 
Obstetricians and Gynecologists, Association of Asian Pacific Community 
Health Organizations, Association of Women's Health, Obstetric and 
Neonatal Nurses, Breastfeeding Coalition of Washington, Breastfeeding 
Task Force of Greater Los Angeles, Global Alliance for Women's Health, 
International Community Health Services, National Association of 
Chronic Disease Directors, National Research Center for Women & 
Families, Society for Women's Health Research, WithinReach, and Women's 
Health Council of the National Association of Chronic Disease 
Directors.
  I ask unanimous consent letters of support be printed in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                          The American Association


                                      of Colleges of Pharmacy,

                                   Alexandria, VA, August 9, 2006.
     Hon. Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: On behalf of America's 92 accredited 
     colleges and schools of pharmacy let me personally thank you 
     for your concern for the nearly 21 million children and 
     adults with diabetes. The American Association of Colleges of 
     Pharmacy (AACP) supports your introduction of legislation 
     focused on an important cohort of individuals at risk for 
     contracting diabetes--pregnant women.
       The Gestational Diabetes Act will bring greater attention 
     to a public health problem that left unchecked will overwhelm 
     our society. Coupled with the growing incidence of obesity, 
     gestational onset diabetes requires new, unique approaches 
     and interventions that your legislation can help stimulate.
       We know that pharmacists are effective in helping diabetic 
     patients improve their health outcomes through self-
     management programs. These community-based providers have 
     been effective in working with the greater public health 
     community to increase the awareness of pregnant women of the 
     need to increase their intake of folic acid to reduce the 
     incidence of neural tube defects in newborns. Colleges and 
     schools of pharmacy are actively engaged in working with 
     communities to reduce the incidence of public health threats 
     and creating novel health promotion and wellness programs. We 
     encourage you to utilize this significant resource as your 
     legislation continues its way through the Congress and on to 
     final passage.
       Thank you for your attention to an important public health 
     threat. We look forward to working with you to improve the 
     health of pregnant women by reducing their risk for 
     gestational diabetes.
           Sincerely,
                                          William G. Lang IV, MPH,
     VP Policy and Advocacy.
                                  ____

                                              American Association


                                        of Diabetes Educators,

                                                   August 8, 2006.
     Senator Hillary Rodham Clinton,
     Russel Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: On behalf of the American Association 
     of Diabetes Educators, I would like to thank you for the 
     introduction of the Gestational Diabetes Act.
       The American Association of Diabetes Educators (AADE) is a 
     multi-disciplinary professional membership organization 
     dedicated to advancing the practice of diabetes self-
     management training and care as integral components of health 
     care for persons with diabetes, and lifestyle management for 
     prevention of diabetes. Our members include nurses, 
     dietitians, pharmacists, physicians, social workers, exercise 
     physiologists and other members of the diabetes teaching 
     team.
       Given the growing prevalence of diabetes in all 
     populations, steps taken now will not only address the need 
     to lower the incidence of gestational diabetes but prevent 
     women with this condition and their children from developing 
     Type 2 diabetes.
       As an organization dedicated to improving the health and 
     lives of people with diabetes, AADE appreciates your 
     leadership on this important legislation and its intent to 
     better understand and reduce the incidence of gestational 
     diabetes.
       Sincerely,
                                     Malinda Peeples, RN, MS, CDE,
     President.
                                  ____



                                American Diabetes Association,

                                   Alexandria, VA, August 3, 2006.
     Hon. Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: Today, almost 21 million children and 
     adults in America have diabetes--including 9.7 million 
     women--and almost one third of them do not know it. On behalf 
     of all Americans living with diabetes in our country, I would 
     like to thank you for the introduction of the Gestational 
     Diabetes Act. The American Diabetes Association 
     enthusiastically supports this important legislation and its 
     intent to better understand and reduce the incidence of 
     gestational diabetes.
       Gestational diabetes develops in 4-8% of all pregnancies, 
     with the prevalence increasing up to 10% in some populations. 
     Women who have had gestational diabetes or have given birth 
     to a baby weighing more than 9 pounds are at a dramatically 
     increased risk for developing type 2 diabetes later in life. 
     The

[[Page S9789]]

     Gestational Diabetes Act will allow for better data 
     collection and expand the resources available to fight this 
     dangerous disease. By setting up a national grant program, 
     communities will be able to determine the most efficient and 
     customized approaches to prevent, diagnose and treat 
     gestational diabetes on the local level. Additionally, grants 
     can be used by state-based diabetes prevention and control 
     programs to collect and analyze surveillance data on women 
     with and at risk for gestational diabetes, among other 
     purposes. These components are crucial to stemming the tide 
     of gestational diabetes in America, and lowering the overall 
     incidence of diabetes in this country.
       Every 24 hours, Americans pay a horrific price to diabetes: 
     4100 people are diagnosed with the disease, there are 230 
     amputations in people with diabetes, 120 people will enter 
     end-stage kidney disease programs, and 55 people will go 
     blind. During this same time period, there will be 613 deaths 
     due to this epidemic. The American Diabetes Association 
     believes that if we are to truly make strides against this 
     devastating disease, we must improve treatment and research 
     on the communities most impacted by diabetes.
       The Association applauds your efforts on behalf of 
     Americans with diabetes. We look forward to working with you 
     toward the passage of the Gestational Diabetes Act and other 
     legislation critical to Americans with diabetes.
           Sincerely,
                                               L. Hunter Limbaugh,
     Chair, National Advocacy Committee.
                                  ____



                                American Dietetic Association,

                                Washington, DC, September 8, 2006.
     Hon. Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: On behalf of the 65,000 registered 
     dietitians who are members of the American Dietetic 
     Association (ADA), we thank you for your leadership in 
     introducing the Gestational Diabetes Act. While gestational 
     diabetes is one of pregnancy's most common complications, the 
     associated risks for mothers with GDM and their children are 
     startling. In the United States, maternal obesity also is a 
     concern and increases the risk of gestational diabetes, 
     cesarean deliveries, and complications during delivery, 
     macrosomia, congenital defects and childhood obesity. ADA has 
     been in the forefront of this issue by developing evidence-
     based Nutrition Practice Guidelines for Gestational Diabetes 
     Mellitus.
       It is the position of the American Dietetic Association 
     that women of childbearing potential should maintain good 
     nutritional status through a lifestyle that optimizes 
     maternal health and reduces the risk of birth defects, 
     suboptimal fetal development, and chronic health problems in 
     their children. The key components of a health promoting 
     lifestyle during pregnancy include appropriate weight gain; 
     consumption of a variety of foods in accordance with the Food 
     Guide Pyramid; appropriate and timely vitamin and mineral 
     supplementation; avoidance of alcohol, tobacco, and other 
     harmful substances; and safe food-handling.
       Women have specific nutritional needs and vulnerabilities 
     and, as such, are at unique risk for various nutrition-
     related diseases and conditions. Therefore, ADA strongly 
     supports research, health promotion activities, health 
     services, and advocacy efforts that will enable women to 
     adopt desirable nutrition practices for optimal health. Women 
     are at risk for numerous chronic diseases and conditions that 
     affect the duration and quality of their lives. Although 
     women's health-related issues are multifaceted, nutrition has 
     been shown to influence significantly the risk of chronic 
     disease and to assist in maintaining optimal health status.
       The American Dietetic Association strongly supports your 
     efforts to create a Research Advisory Committee within CDC to 
     address problems associated with gestational diabetes. 
     Registered dietitians can play a unique role in providing 
     medical nutrition therapy for pregnant women with 
     inappropriate weight gain. As a result, ADA would like to 
     work with you in ensuring that a qualified registered 
     dietitian serves on the committee.
           Sincerely,
                                                  Ronald E. Smith,
     Director of Government Relations.
                                  ____

                                           The American College of


                              Obstetricians and Gynecologists,

                                   Washington, DC, August 4, 2006.
     Hon. Hillary Rodham Clinton,
     U.S. Senate,
     Washington, DC.
       Dear Senator Clinton, On behalf of the American College of 
     Obstetricians and Gynecologists (ACOG), 51,000 physicians and 
     partners in women's health care, we are pleased to support 
     the GEstational DIabetes (GEDI) Act of 2006. This legislation 
     would provide research, monitoring, screening and training 
     for health care providers on gestational diabetes.
       Gestational diabetes mellitus (GDM) is one of the most 
     common clinical issues facing obstetricians and their 
     patients. A lack of data from well-designed studies has 
     contributed to the controversy surrounding the diagnosis and 
     management of this condition. The GEDI Act of 2006 would 
     provide critical funding for research and community education 
     on this important issue. Because of the expertise and solid 
     scientific evidence we have to contribute, we urge you to 
     ensure ACOG's participation on the advisory committee created 
     by this legislation.
       Gestational diabetes affects 4 to 8 percent, approximately 
     135,000, of all pregnant women in the United States each 
     year. The increase in obesity in the U.S. has raised the 
     prevalence of gestational diabetes resulting in significant 
     health consequences, including increased risk for developing 
     Type 2 diabetes. This legislation could help reverse these 
     negative trends.
       Thank you for your continued leadership on women's health 
     care issues and we are pleased to work with you to ensure 
     enactment of this legislation of vital importance to women 
     and babies. Should you have any questions, please contact 
     Krysta Jones, of ACOG's Government Affairs staff.
           Sincerely,
                                                 Douglas W. Laube,
     President.
                                  ____

                                      Association of Asian Pacific


                               Community Health Organizations,

                                      Oakland, CA, August 7, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton, On behalf of the Association of Asian 
     Pacific Community Health Organizations (AAPCHO), I would like 
     to thank you and express our support for the Gestational 
     Diabetes (GEDI) Act of 2006.
       AAPCHO is a non-profit national association of community 
     health organizations. Our mission is to promote advocacy, 
     collaboration and leadership that improves the health status 
     and access of Asian Americans, Native Hawaiians and Pacific 
     Islanders within the U.S. and its territories and freely 
     associated states, primarily through our member community 
     health centers.
       Diabetes is a serious chronic condition among Asian 
     Americans and Pacific Islanders (AAPIs). For FY 2003, AAPCHO 
     member centers, serving primarily AAPIs, reported an average 
     diabetes incidence rate of 11 per 1000 patients, far above 
     the Healthy People 2010 target rate of 2.5 per 1000 patients. 
     The Gestational Diabetes Act will improve treatment and 
     research in the AAPI community.
       We appreciate your efforts and look forward to working with 
     you to improve the health status of AAPIs with diabetes 
     through the GEDI Act and other legislation concerning 
     diabetes. Please contact me if you have any questions or 
     would like additional information.
           Sincerely,
                                                Jeffrey Caballero,
     Executive Director.
                                  ____

                                          Breastfeeding Task Force


                                       of Greater Los Angeles,

                               Redondo Beach, CA, August 14, 2006.
     Sen. Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: On behalf of the Board of Directors 
     of the Breastfeeding Task Force of Greater Los Angeles, I am 
     writing to pledge our support of the Gestational Diabetes Act 
     and urge the inclusion of breastfeeding in the research and 
     treatment components. Gestational diabetes develops in 4 to 8 
     percent of all pregnancies, with the prevalence increasing up 
     to 10 percent in some populations. Women who have gestational 
     diabetes are at a dramatically increased risk for developing 
     Type 2 diabetes later in life.
       We support this legislation because it aims to lower the 
     incidence of gestational diabetes and prevent women afflicted 
     with this condition and their children from developing Type 2 
     diabetes. Research shows that lactation improves maternal 
     glucose homeostasis, thus delaying or reducing the mother's 
     risk of developing Type 2 diabetes. Babies born to mothers 
     with gestational diabetes are at great risk for developing 
     diabetes later in life. When these babies are breastfed, 
     their risk is reduced.
       In Los Angeles County, approximately 10,000 women are 
     afflicted with gestational diabetes each year. The 
     Breastfeeding Task Force of Greater Los Angeles believes that 
     if we are to improve the lives of these women, we must 
     support and protect breastfeeding in the communities most 
     impacted by diabetes. The Gestational Diabetes Act will 
     improve data collection and expand resources available for 
     prevention, diagnosis and treatment. These activities are 
     critical to battling gestational diabetes in America.
       The Breastfeeding Task Force of Greater Los Angeles thanks 
     you for your efforts on behalf of the mothers affected by 
     gestational diabetes and their babies. We look forward to 
     working with you toward the passage of the Gestational 
     Diabetes Act and other legislation critical to mothers and 
     babies.
           Sincerely,
                                                     Karen Peters,
     Executive Director.
                                  ____



                                                       AWHONN,

                                   Washington, DC, August 8, 2006.
     Senator Hillary Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: The Association of Women's Health, 
     Obstetric and Neonatal Nurses (AWHONN) would like to thank 
     you for introducing the Gestational Diabetes Act. AWHONN is a 
     national membership organization of 22,000 nurses, and it is 
     our mission to promote the health and well-being of women and 
     newborns. Our members are staff nurses, nurse practitioners, 
     certified nurse-midwives, and clinical nurse specialists who 
     work in hospitals, physicians' offices, universities, and 
     community clinics throughout the United States. AWHONN 
     supports this

[[Page S9790]]

     important legislation and its intent to better understand and 
     reduce the incidence of gestational diabetes.
       As you know, almost 21 million Americans have diabetes 
     including 9.7 million women. Gestational diabetes develops in 
     4 to 8 percent of all pregnancies with the prevalence rate 
     reaching up to 10 percent in some populations according to 
     the American Diabetes Association. Significant negative 
     health impacts exist for women during and after pregnancy and 
     for infants as a result of gestational diabetes. For example, 
     women and infants run a higher risk for developing Type 2 
     diabetes in their lifetimes; pregnant women are at risk for 
     preeclampsia; and, newborns at risk for having low blood 
     sugar and severe jaundice.
       The Gestational Diabetes Act seeks to establish a Research 
     Advisory Committee that will develop multi-site gestational 
     diabetes research projects to expand and enhance monitoring 
     of gestational diabetes by standardizing procedures for 
     accurate data collection and identifications of this 
     disorder. In addition, the bill allows for demonstration 
     grant programs that are focused on the reduction of the 
     incidence rate of gestational diabetes. Finally, the bill 
     calls for an expansion on current research at the Centers for 
     Disease Control and the National Institutes of Health.
       AWHONN applauds your leadership on this issue, and we 
     support the introduction of the Gestational Diabetes Act. We 
     look forward to working with you towards the passage of this 
     legislation that is critical for improving the research on 
     and treatment of gestational diabetes, which ultimately 
     affects the health and well-being of both women and newborns 
     throughout their lifespan.
           Sincerely,
                                                   Melinda M. Ray,
     Director, Public Affairs.
                                  ____

                                                   Global Alliance


                                           for Women's Health,

                                     New York, NY, August 9, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building, Washington, DC.
       Dear Senator Clinton. The Global Alliance for Women's 
     Health endorses the National Public Health Initiative on 
     Diabetes and Women's Health. It addresses an important and 
     underattended aspect of women's health. The passage and 
     implementation of this initiative will significantly advance 
     the health of American women and will undoubtedly provide 
     guidance for those of us working to advance the health of 
     women worldwide.
           Sincerely,
                                                Elaine M. Wolfson,
     President.
                                  ____

                                           International Community


                                              Health Services,

                                   Washington, DC, August 8, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: International Community Health 
     Services (ICHS) applauds your efforts in raising awareness 
     and support for gestational diabetes research and prevention. 
     ICHS supports the introduction and passage of the Gestational 
     Diabetes Act.
       ICHS is currently a member of the REACH diabetes coalition, 
     a CDC program which provides funding for outreach and 
     education to minority populations, but is limited to people 
     40 years and older. We serve 15,000 patients speaking 35 
     languages with the majority being women in their childbearing 
     years who are disproportionately affected by diabetes. In our 
     2006 community needs assessment diabetes was identified by 
     doctors and community members as one of the highest concerns. 
     Due to this disproportionate affect and community concern, 
     our clinics offer special services for patients with 
     diabetes. Additionally preventing diabetes from developing 
     and mitigating the harmful effects falls in line with the 
     Healthy People 2010 objectives.
       Thank you for taking the lead on the important issue of 
     gestational diabetes. With growing rates of obesity and women 
     becoming mothers later in life, this is a crucial time to 
     take action and provide funding for further research.
       ICHS is proud to support the Gestational Diabetes Act and 
     we commend Senator Clinton for introducing the legislation.
           Sincerely,
                                                Teresita Batayola,
     Executive Director.
                                  ____

                                           National Association of


                                    Chronic Disease Directors,

                                   Washington, DC, August 7, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: Today, almost 21 million children and 
     adults in America have diabetes--including 9.7 million 
     women--and almost one-third of them do not know it. On behalf 
     of all Americans living with diabetes in our country, I would 
     like to thank you for the introduction of the Gestational 
     Diabetes Act. The National Association of Chronic Disease 
     Directors (NACDD), a membership organization of program 
     directors and staff in every state and territorial health 
     department, enthusiastically supports this important 
     legislation and its intent to better understand and reduce 
     the incidence of gestational diabetes.
       Gestational diabetes develops in 4-8 percent of all 
     pregnancies, with the prevalence increasing up to 10 percent 
     in some populations. Women who have had gestational diabetes 
     or have given birth to a baby weighing more than 9 pounds are 
     at a dramatically increased risk for developing type 2 
     diabetes later in life. The Gestational Diabetes Act will 
     allow for better data collection and expand the resources 
     available to fight this dangerous disease. Creating a 
     national program will allow states to determine the most 
     efficient and customized approach to prevent, diagnose and 
     treat gestational diabetes at the local level. Additionally, 
     grants can be used by state-based diabetes prevention and 
     control programs to collect and analyze surveillance data on 
     women with and at risk for gestational diabetes. These 
     components are crucial to stemming the tide of gestational 
     diabetes in America and lowering the overall incidence of 
     diabetes in this country.
       Every 24 hours, Americans pay a horrific price to diabetes: 
     4,100 people are diagnosed with the disease, there are 230 
     amputations in people with diabetes, 120 people will enter 
     end-stage kidney disease programs, and 55 people will go 
     blind. During this same time period, there will be 613 deaths 
     due to this epidemic. The National Association of Chronic 
     Disease Directors believes that if we are to truly make 
     strides against this devastating disease, we must improve 
     prevention and control in the communities most impacted by 
     diabetes.
       NACDD applauds your efforts on behalf of Americans with 
     diabetes. We look forward to working with you toward the 
     passage of the Gestational Diabetes Act and other legislation 
     critical to Americans with diabetes.
           Sincerely,
                                                 David P. Hoffman,
     Chair, Legislative and Policy Committee.
                                  ____

                                          National Research Center


                                         for Women & Families,

                               Washington, DC, September 12, 2006.
     Hon. Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: The National Research Center for 
     Women & Families applauds your leadership in introducing the 
     ``GEstational DIabetes (GEDI) Act of 2006''.
       We share your concern that gestational diabetes is 
     associated with potentially serious health problems for the 
     mother and child during and after childbirth. Gestational 
     diabetes increases a mother and child's risk for developing 
     Type 2 diabetes. With 135,000 women per year being diagnosed 
     with gestational diabetes and that number steadily 
     increasing, it is necessary to better understand the disease 
     and to prevent the development of Type 2 diabetes. Data 
     collection and monitoring gestational diabetes and obesity 
     during pregnancy are essential first steps. The GEDI Act's 
     data systems, demonstration grants, and research expansion 
     will all aid in lowering the incidence of gestational 
     diabetes and will help prevent Type 2 diabetes.
       Thank you again for your vision and leadership in drawing 
     attention to this and many other important health issues.
           Sincerely,
                                               Diana M. Zuckerman,
     President.
                                  ____

                                               Society for Women's


                                              Health Research,

                                  Washington, DC, August 11, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: Today, almost 21 million children and 
     adults in America have diabetes, including 9.7 million women. 
     Gestational diabetes develops in 4-8 percent of all 
     pregnancies, with the prevalence increasing up to 10 percent 
     in some populations. On behalf of all Americans living with 
     diabetes in our country, the Society for Women's Health 
     Research (SWHR) thanks you for the introduction of the 
     Gestational Diabetes Act.
       As the nation's only advocacy organization committed to 
     improving the health of all women through research, the 
     Society supports this important legislation, with its focus 
     on learning more about treatment and prevention of 
     gestational diabetes through research. The Gestational 
     Diabetes Act will allow for better data collection and to 
     analyze surveillance data on women with and at risk for 
     gestational diabetes, among other purposes. These components 
     are crucial to stemming the tide of gestational diabetes in 
     America, and lowering the overall incidence of diabetes in 
     this country.
       Thank you for your leadership and your support of women's 
     health research.
           Sincerely,
     Phyllis Greenberger,
       President & CEO.
     Martha Nolan,
       Vice President, Public Policy.
                                  ____



                                                  WithinReach,

                                      Seattle, WA, August 9, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: Thank you for the introduction of the 
     Gestational Diabetes Act. WithinReach (formerly Healthy 
     Mothers, Healthy Babies Coalition of Washington State) and 
     the Breastfeeding Coalition of Washington State (a program of 
     WithinReach) enthusiastically support this legislation and 
     the need for Americans to better understand and reduce the 
     incidence of gestational diabetes.

[[Page S9791]]

       You may not be aware of the connection between early 
     nutrition and its impact on diabetes. Specifically, not 
     breastfeeding increases the risk of diabetes (in both infant 
     and mother). A review of the literature by Schaefer-Graf et 
     al, demonstrate that among children of women who have GDM, 
     having been breast fed for over 3 months is negatively 
     associated with being overweight in early childhood. In this 
     group, the risk of childhood overweight was reduced by 40-50 
     percent. The effect was most pronounced when the mother was 
     obese.
       Breastfeeding mothers provide their children with a lower 
     risk of infection and chronic diseases. There is a clear 
     dose-response relationship between duration of breastfeeding 
     and the extent of risk reduction. Breastfeeding improves the 
     health of infants and mothers and can result in cost savings 
     for parents, insurers, employers, and society. The medical 
     and economic value of breast feeding is high. Support from 
     employers, health insurers, health providers, and society are 
     required to reach the goals set forth in Healthy People 2010 
     including 75 percent of mothers initiating breastfeeding, 50 
     percent of infants receiving breastmilk at 6 months, and 25 
     percent of infants breastfeeding at 1 year of age.
       Most women want to breastfeed and deserve our help in 
     fulfilling their goals, including providing them societal 
     support and sparing them societal experiences that make it 
     difficult to succeed. The GeDi Act and an increased rate of 
     breast feeding will proactively improve the health of 
     Americans, as well as decrease diabetes and its related 
     illnesses and medical costs.
       WithinReach and the Breastfeeding Coalition of Washington 
     State applaud your efforts and ask that you ensure the 
     important health and economic connection between breast 
     feeding and diabetes is made.
           Sincerely,
     Ginny English,
       Executive Director, WithinReach.
     Kimberly Radtke,
       Coordinator, Breastfeeding Coalition of Washington.
                                  ____

                                           National Association of


                                    Chronic Disease Directors,

                                   Washington, DC, August 8, 2006.
     Senator Hillary Rodham Clinton,
     Russell Senate Office Building,
     Washington, DC.
       Dear Senator Clinton: Current national behavioral health 
     statistics reveal that 7.2 percent of U.S. women 18 years of 
     age and older have diabetes. This number is underestimated 
     due to 30 percent of women who have diabetes have not been 
     diagnosed. Of the women surveyed, 1.6 percent states that 
     their diabetes was pregnancy related or Gestational diabetes. 
     Gestational diabetes occurs in 4-8 percent of pregnancies and 
     places both the woman and her infant at greater risk for 
     developing type 2 diabetes and is associated with health 
     problems for both woman and child during the pregnancy and 
     childbirth. With the increasing rise in obesity, the 
     prevalence of gestational diabetes is also rising, however 
     genetics, ethnicity, and maternal age are risk factors for 
     the disease. Over the last several decades, the science of 
     diagnosing and treating Gestational Diabetes advanced, but 
     additional research is needed to understand the complex 
     interrelationships of obesity, genetics, ethnicity and 
     diabetes in women.
       Women and diabetes are major priorities of the Women's 
     Health Council of the National Association of Chronic Disease 
     Directors. The Council is currently studying the issues 
     surrounding diabetes and young women through the ``Pregnancy 
     Risk Assessment Surveillance System. The Council supports 
     your proposed legislation as the legislation further enhances 
     the science of diabetes and its impact on women. Also, the 
     Women's Health Council serves as an active member of the 
     National Public Health Initiative on Diabetes and Women's 
     Health and this proposed legislation furthers the objectives 
     of this Initiative.
       The Gestational Diabetes Act creates a Research Advisory 
     Committee headed by the CDC and includes representatives of 
     federal agencies, and health organizations to develop 
     demonstration grants funding multi-site gestational diabetes 
     research projects to expand and enhance monitoring of 
     gestational diabetes by standardizing procedures for accurate 
     data collection and identifying this disorder. This bill also 
     tracks mothers who had gestational diabetes and develop 
     methods to prevent their development of Type 2 diabetes.
       Thank you for developing policy that supports women and 
     their health status.
           Sincerely,
                                                   Adeline Yerkes,
     Chairperson, Women's Health Council.

                          ____________________