[Congressional Record Volume 170, Number 173 (Thursday, November 21, 2024)]
[Senate]
[Pages S6708-S6709]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                        American Diabetes Month

  Mrs. SHAHEEN. Madam President, I am pleased to come to the floor with 
my colleague Senator Collins to talk about the fact that this week the 
Senate passed a resolution designating November as American Diabetes 
Month.
  Every November, we work together--my friend and colleague, my fellow 
cochair of the Senate Diabetes Caucus, Senator Collins--to pass this 
resolution so that we can raise awareness about what is a pervasive, 
chronic disease that 38 million Americans live with today. The 
resolution also draws attention to the many barriers that patients face 
when it comes to receiving adequate care to manage their diabetes.
  By passing this resolution out of the Senate, we are reaffirming 
Congress's commitment to increase diabetes treatment options, to fund 
more research, and to prevent new cases.
  While I am grateful that the Senate has passed this resolution again 
this year, I wish I could say that we are truly honoring the commitment 
that is outlined in the resolution. But, sadly, I am angry and I am 
frustrated over the lack of progress that spans not just years but 
decades to make commonsense changes and find real solutions to the 
problems that face diabetes patients.
  For 38 million Americans, this isn't a matter of politics, of what 
political party you join or if you don't belong to one; for those 38 
million, it is actually a matter of life or death, literally.
  This is an issue, as I have said to this body many times, that is 
personal for me and my family. In the Gallery today is my granddaughter 
Elle, who was diagnosed with type 1 diabetes shortly before her 8th 
birthday. I have seen firsthand the challenges that Elle, my daughter 
Stefany, and their family face trying to manage Elle's diabetes.
  Managing type 1, especially when you get diagnosed at such a young 
age, is a complicated, delicate balance of daily insulin injections, 
blood glucose monitoring, and other supporting drugs. Elle and her mom 
and her dad have spent countless hours finding a treatment regimen that 
keeps her blood glucose level stable and allows her to live a full, 
happy life.
  Elle is now 24. She lives in L.A., and she has spent years 
advocating, herself, to improve diabetes policies as part of 
Breakthrough T1D, which was formerly JDRF. Yet, every year, Elle, like 
all diabetes patients on some insurance, has to prove to her insurer 
that she still has type 1. Now, I find that strange because anybody who 
knows anything about type 1 knows that it is a chronic illness, that it 
doesn't go away. And I am angry because this is real for our family and 
for millions of families across the country. And it is scary.
  Just this week, Elle was denied coverage for a prescription that she 
relies on to manage her diabetes. She was denied a medication that she 
needs to live her very busy and full life. The medication she was 
denied does the same work of three other drugs combined. Now all of 
Elle's work to find the right treatment is back to square one because 
of a decision that was made not by her doctor--and she has been a 
patient at the Joslin Diabetes Center, which is one of the premier 
diabetes treatment centers not just in the country but in the world. It 
wasn't her doctor at the Joslin Center who made that decision. It 
wasn't her local primary care doctor. It was the insurance company.
  I wish I could say this was the first time, but denials like these 
have become a common occurrence. And I think most folks know this, but 
in case you don't, as I said, type 1 diabetes is a chronic disease. It 
doesn't go away because you turn another year older. It doesn't go away 
because you move to a different location. Elle is going to live with 
this disease, unless we have a breakthrough, for the rest of her life, 
and she will spend, every day, some portion of her day thinking about 
it. She will spend every day making choices about what to eat or drink, 
about the right exercise routine, and how she can best manage her 
levels. It is unconscionable that a decision by an insurer would make 
these choices even harder.
  We are lucky in our family because we have resources and we have time 
to dedicate to researching and solving some of these issues, to try to 
navigate the healthcare system, but, sadly, that is not the case for so 
many families across this country, people like the single mom who works 
multiple jobs to keep food on the table for her kids.
  I understand why Americans are angry with the status quo. They should 
be. We should all be because it is well past time we finally get help 
to those people who need it to address their type 1 diabetes.
  I know that Senator Collins and I have legislation. It is called the 
INSULIN Act. It is an effort to help people who cannot afford the cost 
of their insulin. We know that is an issue because spending on insulin 
has tripled in the last decade. Nearly one in five patients is still 
forced to ration their insulin.
  Capping out-of-pocket costs for insulin and finding ways to increase 
insulin competition are no-brainers for most Americans. Sadly, that 
hasn't been true in the Senate. In fact, this is an issue that receives 
so much support from the American people that addressing insulin costs 
has, sadly, become a political football. Unfortunately, that comes at 
the expense of patients who rely on daily insulin to survive.
  Senator Collins and I started working on this issue--our legislation 
in 2019. Part of the effort includes funding more research into curing 
diabetes. The diabetes community has seen advances in treatment, but 
insulin, which was invented over 100 years ago, is still the only real 
way to manage the disease.
  The Special Diabetes Program, or SDP, funds vital research into type 
1 at the National Institutes of Health. SDP also funds successful 
diabetes prevention and treatment programs for American Indian and 
Alaskan Native communities because they are disproportionately affected 
by the disease. These programs have a proven track record, but until 
last year, the Special Diabetes Program was flat-funded for two 
decades.
  Senator Collins has done remarkable work, and I think it is not a 
coincidence that when she became vice chair of the Appropriations 
Committee, we finally got an increase in the reauthorization of the 
Special Diabetes Program. But we have to pass that reauthorization 
again by the end of this year.
  Now, I hope Congress will finally realize the importance of this 
program and provide it the funding that it deserves. I hope that we can 
also get this body to pass our INSULIN Act because, for Elle, for 
families across this country, in every corner of every State, we

[[Page S6709]]

have to do better for all of them, for the people who love them, 
because behind every statistic is a person who is just trying to make 
ends meet.
  We have the power here to make their lives easier, to make healthcare 
more affordable for the millions of people who are living with 
diabetes. We can create a future where no one has to choose between 
their health and their livelihood. Why wouldn't we take this 
opportunity to help our neighbors? I know Senator Collins and I will 
continue to work toward that end.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Maine.
  Ms. COLLINS. Madam President, first, let me thank the Senator from 
New Hampshire, Senator Shaheen, for her extraordinary leadership on 
diabetes. She has worked night and day on this issue the entire time 
she has served in the Senate. Together we formed a bipartisan 
partnership that recognizes that diabetes affects men and women and 
children of all races, political affiliations, parts of the country. It 
is ageless. It simply does not care.
  During American Diabetes Month, it is critical that we continue to 
raise awareness about the burden of diabetes on the 38 million 
Americans living with either type 1 or type 2 diabetes. This is an 
astonishing 12 percent of the U.S. population, and it includes more 
than 116,000 adults in my State of Maine.
  For those with type 1 diabetes in particular, there is no day off 
from this disease. I know so many children who were diagnosed as 
children with type 1, and this is a disease they will have for the rest 
of their lives, absent a cure. They include a 10-year-old boy whom I 
met my very first year in the Senate, in 1997. I will never forget his 
looking up at me and saying: Senator Collins, I wish I could just have 
one day off each year from my diabetes--my birthday or Christmas--just 
one day.
  It was then that I knew I had to dedicate my efforts toward better 
treatments, earlier diagnosis, and one day a cure of this devastating 
disease. Since then, my life has been enriched by getting to know so 
many people who have type 1 diabetes.
  I think of Aidan Sweeney, whom I first met at a Children's Congress, 
where children from all over the United States came to Washington to 
talk about what it was like to have type 1 diabetes. Aidan was just a 
toddler when he came with his mother Caroline Sweeney to testify before 
Congress. She testified for him. Today, he is a thriving college 
student in Boston.
  I think of people like Ruby Whitmore, one of my neighbors in Maine, 
who has had diabetes since a very young age.
  I think of my niece Nicole Wiesendanger, who has kept a log, a 
journal of her journey with type 1 diabetes.
  I think of Bek Hoskins, whom I met just this past year, who, because 
of the price of insulin, felt that she could not take the full amount 
that she was advised to take by her doctor and ended up in the 
emergency room of a hospital, very ill.
  I am appalled to learn of the experience of Senator Shaheen's 
granddaughter, who has lived with type 1 since she was just 8 years old 
and was recently denied care that she requires. I agree with Senator 
Shaheen that we must hold insurance carriers accountable when they 
apply unreasonable utilization management techniques that benefit the 
companies at the expense of everyday Americans and that contradict the 
best treatment for the person with type 1. Doctors and patients in 
Maine are frustrated with the unfair burden these practices add to the 
burdens these individuals are already coping with. We must and we can 
do better.
  Diabetes is also one of our country's most costly diseases in both 
human and economic terms. It is the leading cause of kidney disease, 
blindness in working-age adults, lower limb amputations, heart disease, 
and stroke. Approximately one in four healthcare dollars and one in 
three Medicare dollars are spent treating people with diabetes. 
Diabetes cost our Nation $413 billion in 2022, and medical expenditures 
for individuals coping with diabetes are roughly 2.6 times higher than 
expenditures for those without the disease.
  As the founder and the cochair of the Senate Diabetes Caucus, I have 
been proud to lead this bipartisan resolution designating the month of 
November as ``American Diabetes Month.'' My hope is that it will 
increase public awareness and support for Federal policies and 
investments that will help us to better treat, prevent, and ultimately 
cure this disease. I join Senator Shaheen in thanking our many Senate 
colleagues for supporting this resolution and passing it by unanimous 
consent on Tuesday.

  While American Diabetes Month is an important opportunity to raise 
awareness about the burden of diabetes, it should also be a time to 
celebrate the progress that we have made in improving the lives of 
millions of Americans living with this disease.
  One example of progress is the sustained Federal investments in 
programs that help prevent and treat the disease and its complications, 
including the Special Diabetes Program, which, as Senator Shaheen 
pointed out, is set to expire at the end of this year. We cannot allow 
that to occur. Earlier this month, I was proud to lead a bipartisan 
letter to our Senate leadership, signed by 55 Senators, emphasizing the 
importance of the Special Diabetes Program.
  From new technologies like the artificial pancreas systems to new 
therapies to delay the clinical onset of type 1 diabetes, this program 
is improving the lives of people with diabetes today and accelerating 
the progress to cures.
  I remember when I first became involved in this issue, the number of 
daily finger pricks that were necessary, the alarms that had to be set 
during the nights so that parents could check on their children with 
type 1, the burdensome large pump systems that were used. We have come 
so far with the closed-loop artificial pancreas, the continuous glucose 
monitors that can send a phone message and an alarm to a parent if a 
child's blood sugar has become too high or too low. We have come a long 
way. But it has taken investment, and that is what we must continue.
  Through continued Federal investment in biomedical research and 
prevention programs and by passing bipartisan legislation to address 
the high costs of insulin, like our INSULIN Act, as well as broader 
pharmacy benefit manager reform, Congress has the opportunity to 
continue to build on this progress for the benefit of those living with 
diabetes.
  Madam President, I look forward to continuing to partner with Senator 
Shaheen and the members of the Senate Diabetes Caucus that we cochair 
to advance policies, to remove barriers to care, to lower the costs of 
insulin, and to support the critical research and prevention programs 
that are so important to the quality of life to those millions of 
Americans living with diabetes.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CARDIN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Booker). Without objection, it is so 
ordered.
  The senior Senator from Maryland.