[Congressional Record (Bound Edition), Volume 156 (2010), Part 12]
[House]
[Pages 16936-16937]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    GESTATIONAL DIABETES ACT OF 2010

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 5354) to establish an Advisory Committee on Gestational 
Diabetes, to provide grants to better understand and reduce gestational 
diabetes, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 5354

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Gestational Diabetes Act of 
     2010'' or the ``GEDI Act''.

     SEC. 2. GESTATIONAL DIABETES.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by adding after section 317H 
     the following:

     ``SEC. 317H-1. GESTATIONAL DIABETES.

       ``(a) Understanding and Monitoring Gestational Diabetes.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     in consultation with the Diabetes Mellitus Interagency 
     Coordinating Committee established under section 429 and 
     representatives of appropriate national health organizations, 
     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.
       ``(2) Areas to be addressed.--The research project 
     developed under paragraph (1) shall address--
       ``(A) procedures to establish accurate and efficient 
     systems for the collection of gestational diabetes data 
     within each State and commonwealth, territory, or possession 
     of the United States;
       ``(B) 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;
       ``(C) postpartum methods of tracking women with gestational 
     diabetes after delivery as well as targeted interventions 
     proven to lower the incidence of type 2 diabetes in that 
     population;
       ``(D) variations in the distribution of diagnosed and 
     undiagnosed gestational diabetes, and of impaired fasting 
     glucose tolerance and impaired fasting glucose, within and 
     among groups of women; and
       ``(E) factors and culturally sensitive interventions that 
     influence risks and reduce the incidence of gestational 
     diabetes and related complications during childbirth, 
     including cultural, behavioral, racial, ethnic, geographic, 
     demographic, socioeconomic, and genetic factors.
       ``(3) Report.--Not later than 2 years after the date of the 
     enactment of this section, and annually thereafter, the 
     Secretary shall generate a report on the findings and 
     recommendations of the research project including prevalence 
     of gestational diabetes in the multisite area and disseminate 
     the report to the appropriate Federal and non-Federal 
     agencies.
       ``(b) Expansion of Gestational Diabetes Research.--
       ``(1) In general.--The Secretary shall expand and intensify 
     public health research regarding gestational diabetes. Such 
     research may include--
       ``(A) developing and testing novel approaches for improving 
     postpartum diabetes testing or screening and for preventing 
     type 2 diabetes in women with a history of gestational 
     diabetes; and
       ``(B) conducting public health research to further 
     understanding of the epidemiologic, socioenvironmental, 
     behavioral, translation, and biomedical factors and health 
     systems that influence the risk of gestational diabetes and 
     the development of type 2 diabetes in women with a history of 
     gestational diabetes.
       ``(2) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $5,000,000 
     for each fiscal year 2012 through 2016.
       ``(c) Demonstration Grants to Lower the Rate of Gestational 
     Diabetes.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall award grants, on a competitive basis, to eligible 
     entities for demonstration projects that implement evidence-
     based interventions to reduce the incidence of gestational 
     diabetes, the recurrence of gestational diabetes in 
     subsequent pregnancies, and the development of type 2 
     diabetes in women with a history of gestational diabetes.
       ``(2) Priority.--In making grants under this subsection, 
     the Secretary shall give priority to projects focusing on--
       ``(A) helping women who have 1 or more risk factors for 
     developing gestational diabetes;
       ``(B) working with women with a history of gestational 
     diabetes during a previous pregnancy;
       ``(C) providing postpartum care for women with gestational 
     diabetes;
       ``(D) tracking cases where women with a history of 
     gestational diabetes developed type 2 diabetes;
       ``(E) educating mothers with a history of gestational 
     diabetes about the increased risk of their child developing 
     diabetes;
       ``(F) working to prevent gestational diabetes and prevent 
     or delay the development of type 2 diabetes in women with a 
     history of gestational diabetes; and
       ``(G) achieving outcomes designed to assess the efficacy 
     and cost-effectiveness of interventions that can inform 
     decisions on long-term sustainability, including third-party 
     reimbursement.
       ``(3) Application.--An eligible entity desiring to receive 
     a grant under this subsection shall submit to the Secretary--
       ``(A) an application at such time, in such manner, and 
     containing such information as the Secretary may require; and
       ``(B) a plan to--
       ``(i) lower the rate of gestational diabetes during 
     pregnancy; or
       ``(ii) develop methods of tracking women with a history of 
     gestational diabetes and develop effective interventions to 
     lower the incidence of the recurrence of gestational diabetes 
     in subsequent pregnancies and the development of type 2 
     diabetes.
       ``(4) Uses of funds.--An eligible entity receiving a grant 
     under this subsection shall use the grant funds to carry out 
     demonstration projects described in paragraph (1), 
     including--
       ``(A) expanding community-based health promotion education, 
     activities, and incentives focused on the prevention of 
     gestational diabetes and development of type 2 diabetes in 
     women with a history of gestational diabetes;
       ``(B) aiding State- and tribal-based diabetes prevention 
     and control programs to collect, analyze, disseminate, and 
     report surveillance data on women with, and at risk for, 
     gestational diabetes, the recurrence of gestational diabetes 
     in subsequent pregnancies, and, for women with a history of 
     gestational diabetes, the development of type 2 diabetes; and
       ``(C) training and encouraging health care providers--
       ``(i) to promote risk assessment, high-quality care, and 
     self-management for gestational diabetes and the recurrence 
     of gestational diabetes in subsequent pregnancies; and
       ``(ii) to prevent the development of type 2 diabetes in 
     women with a history of gestational diabetes, and its 
     complications in the practice settings of the health care 
     providers.
       ``(5) Report.--Not later than 4 years after the date of the 
     enactment of this section, the Secretary shall prepare and 
     submit to the Congress a report concerning the results of the 
     demonstration projects conducted through the grants awarded 
     under this subsection.
       ``(6) Definition of eligible entity.--In this subsection, 
     the term `eligible entity' means a nonprofit organization 
     (such as a nonprofit academic center or community health 
     center) or a State, tribal, or local health agency.
       ``(7) Authorization of appropriations.--There is authorized 
     to be appropriated to carry out this subsection $5,000,000 
     for each fiscal year 2012 through 2016.
       ``(d) Postpartum Follow-up Regarding Gestational 
     Diabetes.--The Secretary, acting through the Director of the 
     Centers for Disease Control and Prevention, shall work with 
     the State- and tribal-based diabetes prevention and control 
     programs assisted by the Centers to encourage postpartum 
     follow-up after gestational diabetes, as medically 
     appropriate, for the purpose of reducing the incidence of 
     gestational diabetes, the recurrence of gestational diabetes 
     in subsequent pregnancies, the development of type 2 diabetes 
     in women with a history of gestational diabetes, and related 
     complications.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Texas (Mr. Burgess) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, as many as 135,000 women in the United States each year 
develop gestational diabetes, and this number is steadily growing. Many

[[Page 16937]]

women who have had gestational diabetes later developed type 2 
diabetes. Babies born to women with gestational diabetes are also at 
risk for high birth weight.
  The Gestational Diabetes Act, sponsored by Representatives Engel and 
Burgess, will expand research and grant resources available through the 
Department of Health and Human Services to fight this dangerous 
disease. It is an important piece of legislation. I urge my colleagues 
to support the bill.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself as much time as I may 
consume.
  I rise today in strong support of H.R. 5354. I worked on this bill 
with Mr. Engel. This bill has gone through regular order and passed the 
Energy and Commerce Committee unanimously, and I thank all of the staff 
involved, from the personal staff levels of Mr. Engel's office and 
mine, and the committee staff for their hard work on the bill before us 
today.
  As an obstetrician, I have witnessed the effect of gestational 
diabetes on both mother and child. Gestational diabetes is a growing 
problem, and we really don't know why. Unlike type 2 diabetes, 
gestational diabetes has a very different issue, requiring a unique 
approach.
  Gestational diabetes affects between 2 and 5 percent of pregnant 
women, about 135,000 cases in the United States each year, and usually 
occurs late in pregnancy. If left untreated, gestational diabetes can 
have a significant impact on both mother and child. Women and children 
affected by gestational diabetes are at higher risk of developing type 
2 diabetes, and it is associated with additional health problems for 
both mother and child during both pregnancy and childbirth.
  In addition, once a mother contracts gestational diabetes, her 
chances are 2 in 3 that it may return in future pregnancies. That is 
why this act, the Gestational Diabetes Act of 2009, is a vital 
investment in our future. This bill will allow for the collection of 
data and the study of risk factors, as well as continued postpartum 
evaluations, with the goal of developing proven intervention strategies 
that will lower the rates of gestational diabetes.
  For example, maternal obesity is an independent and more important 
risk factor for large infants and women with gestational diabetes than 
it is with simple glucose intolerance.
  This legislation has the support of many groups, including the 
American Diabetes Association, the American Association of Diabetes 
Educators, the American College of Obstetricians and Gynecologists.
  There is currently an insufficient system for monitoring cases of 
gestational diabetes to uncover trends and target at-risk populations.
  This legislation will go beyond what we do know and promote public 
health research to understand the epidemiological, socioenvironmental, 
behavioral, translation, and biomedical factors that influence the risk 
of gestational diabetes and type 2 diabetes. Current treatments are 
primarily focused on diet and exercise, but there is general 
disagreement about the degree to which each should be recommended and 
the overall effectiveness of this approach. There needs to be greater 
understanding by both providers and patients on how to prevent and 
treat this condition. New therapies and interventions to detect, treat 
and slow the incidence of gestational diabetes need to be identified. 
Through targeted research we will be able to identify triggers that 
result in gestational diabetes in women with no previous risk factors. 
Given the tremendous impact for this disease, I urge support of the 
legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield back the balance of my time and 
urge passage of the bill.
  Mr. ENGEL. Mr. Speaker, I am proud to stand here today as the sponsor 
of the Gestational Diabetes Act and urge my colleagues to support this 
important bipartisan legislation.
  I would like to thank my colleague and an original sponsor of the 
legislation, Dr. Burgess and his staff member, James Paluskiewicz for 
their efforts on behalf of this legislation. I would also like to thank 
the Committee staff who worked tirelessly to bring this bill to the 
floor today. Specifically, I would like to acknowledge Anne Morris of 
the Energy and Commerce Committee and Emily Gibbons of the Health 
subcommittee who is also a former member of my staff.
  Mr. Speaker, every single year 135,000 women in the United States are 
diagnosed with gestational diabetes. And, while gestational diabetes 
generally goes away after pregnancy, it can have significant health 
impacts upon both the mother and baby. In particular, women are at much 
higher risk of developing Type 2 diabetes in the future, and their 
children are at higher risk of obesity and/or the onset of Type 2 
diabetes as adults.
  This is why I introduced the GEDI Act. This bill aims to lower the 
incidence of gestational diabetes and prevent women afflicted with this 
condition and their children from developing Type 2 diabetes.
  We need to have a greater understanding on how to prevent and treat 
this condition. There is currently an insufficient system for 
monitoring cases of gestational diabetes to uncover trends and target 
at risk populations. In addition, new therapies and interventions to 
detect, treat and slow the disease need to be identified. The GEDI Act 
will help us accomplish those goals.
  This legislation is supported by the American Diabetes Association, 
the American Association of Colleges of Pharmacy, American Association 
of Diabetes Educators, the American Congress of Obstetricians and 
Gynecologists, the American Medical Women's Association, the 
Association of Women's Health, Obstetric and Neonatal Nurses, the 
International Community Health Services, and the Society for Women's 
Health Research.
  The statistics surrounding diabetes are staggering, but we must 
always remember there is a human face behind every number, with far too 
many of them being pregnant women and their children.
  Mr. Speaker, I urge my colleagues to vote in favor of this important 
legislation.
  Mr. BURGESS. Mr. Speaker, seeing no further speakers on my time, I 
will just say the increased incidence in the United States has raised 
the prevalence, but the risk of gestational diabetes can also be due to 
genetics, ethnicity, and maternal age. The rates of gestational 
diabetes are higher among women of African American, Hispanic, Asian 
and Native American descent. In addition, there is currently an 
insufficient system for monitoring cases of gestational diabetes, which 
this legislation will begin to correct.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 5354, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BURGESS. Mr. Speaker, I object to the vote on the ground that a 
quorum is not present and make the point of order that a quorum is not 
present.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.
  The point of no quorum is considered withdrawn.

                          ____________________