[Congressional Record Volume 155, Number 109 (Monday, July 20, 2009)]
[Senate]
[Pages S7703-S7704]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. HAGAN (for herself and Mr. Cornyn):
  S. 1473. A bill to catalyze change in the care and treatment of 
diabetes in the United States; to the Committee on Health, Education, 
Labor, and Pensions.
  Mrs. HAGAN. Mr. President, today I am proud to introduce the Catalyst 
to Better Diabetes Care Act, which is S. 1473. Without question, 
diabetes is an epidemic in our country, and we have to do something. 
Twenty-three million adults and children suffer from diabetes. Another 
57 million Americans are prediabetic cases. In North Carolina, my 
State, 600,000 adults have been diagnosed with diabetes and another 
288,000 are undiagnosed and over 400,000 have prediabetes. But with our 
lifestyle choices, it is not surprising that these numbers are so high. 
Nearly three in five North Carolinians are overweight

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or obese. Being overweight is a leading cause of diabetes. A quarter of 
our State's citizens do not exercise. Unfortunately, it is not just 
adults who are suffering from this disease. In North Carolina, there 
are over 4,000 children who have diabetes. While type 1 diabetes is the 
most frequent diabetes in children, it is because of increasing obesity 
rates that the incidence and prevalence of type 2 diabetes is growing.
  Not only is diabetes wreaking havoc on people's health, it is also 
costing the country millions of dollars to treat. In my State of North 
Carolina, diabetes costs $5.3 billion annually in medical 
interventions, lost productivity, and premature mortality. Annually 
diabetes accounts for 16,000 hospitalizations. People suffering from 
diabetes have greater risk of renal disease, heart attack, stroke, and 
blindness. Diabetics also have a high risk of amputations if they fail 
to get appropriate foot care.
  However, with proper prevention and treatment, we can curb the 
staggering cost of diabetes and people can live healthier, happier 
lives. Lifestyle changes in diet and physical activity can reduce the 
development of diabetes in prediabetics. Early detection and treatment 
of diabetic eye disease can reduce blindness and lowering one's blood 
pressure can reduce the decline in kidney function, thereby averting 
renal failure. It is because of these proven interventions that I 
introduce this important bill today.
  The Catalyst to Better Diabetes Care Act will address five major 
issues to further the fight against this debilitating and deadly 
disease. This bill creates a cross-agency, collaborative patient and 
provider outreach program to increase the utilization of the Medicare 
diabetes screening benefit. Although this screening program was 
established in 2003, at present, very few seniors are taking advantage 
of this benefit. Early screening allows diabetics to better monitor and 
control their condition and prevent complications. This provision will 
save money and lives. When employees have incentives to select more 
nutritious food and to exercise, not only are they more productive, 
their overall health is improved. Companies like Pitney Bowes are 
implementing innovative practices to encourage their employees to live 
healthier lives, and such initiatives have shown remarkable results.
  Building upon these experiences, this bill establishes an advisory 
group to promote innovative private sector wellness and disease 
management programs. Diabetes takes an enormous toll on society. Yet we 
have very little consolidated data which measures the true impact and 
outcome of this disease. To address this gap, this bill creates a 
national and State-by-State level diabetes report card which will track 
our progress toward beating diabetes. The report card will contain 
information on preventative care practices and quality of care, risk 
factors, and outcomes of individuals who are diagnosed with diabetes 
and prediabetes.
  Studies indicate that only 35 to 40 percent of diabetics who die have 
diabetes listed anywhere on their death certificate, and only about 10 
to 15 percent have diabetes listed as the underlying cause of death. 
Without this information, our country is not able to grasp the full 
impact that complications from diabetes has on our health care system 
and society.
  In order to better understand the scope of this epidemic, this bill 
requires the director of the CDC to promote the education and training 
of physicians on properly completing a birth and death certificate as 
well as the possibility of promoting language to improve the collection 
of diabetes mortality data, despite estimates that nearly one in three 
children today will go on to develop diabetes. Today's medical students 
are only required to have 4 hours of education in diabetes to become a 
board-certified physician. As diabetes touches more and more Americans, 
it will be critical that our doctors recognize this disease and have 
the tools and understanding to discuss prevention and proper treatment 
with their patients. That is why this bill requires HHS to collaborate 
with the Institute of Medicine and other related entities to study the 
impact of diabetes on the practice of medicine and develop 
recommendations to appropriate levels of diabetes medical education 
that should be required prior to licensure, board certification, and 
board recertification.
  Diabetes has taken an enormous toll on our society's health and our 
economy. But in many cases, this disease can be preventable.
  The Catalyst of Better Diabetes Care will address some of the 
fundamental obstacles that prevent us from tackling this disease head 
on. Better outreach, better data, and better education of patients and 
physicians are the keys to reducing morbidity and mortality from 
diabetes and lessening the costly burden this condition has inserted 
upon our country.
  I wish to thank my Republican colleague, Senator John Cornyn, for 
joining me in cosponsoring this measure. I urge my other colleagues to 
join us in supporting this very important bill.

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