[House Report 111-633]
[From the U.S. Government Publishing Office]
111th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 111-633
======================================================================
GESTATIONAL DIABETES ACT OF 2010
_______
September 28, 2010.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Waxman, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 5354]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
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, having
considered the same, report favorably thereon with amendments
and recommend that the bill as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 4
Background and Need for Legislation.............................. 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings and Recommendations................. 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Statement of General Performance Goals and Objectives............ 5
Constitutional Authority Statement............................... 5
Earmarks and Tax and Tariff Benefits............................. 5
Federal Advisory Committee Statement............................. 5
Applicability of Law to the Legislative Branch................... 5
Federal Mandates Statement....................................... 5
Committee Cost Estimate.......................................... 6
Congressional Budget Office Cost Estimate........................ 6
Section-by-Section Analysis of the Legislation................... 7
Explanation of Amendment......................................... 8
Changes in Existing Law Made by the Bill, as Reported............ 8
Amendment
The amendments are as follows:
Strike all after the enacting clause and insert the
following:
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.''.
Amend the title so as to read:
A bill to provide grants to better understand and reduce
gestational diabetes, and for other purposes.
Purpose and Summary
H.R. 5354, the ``Gestational Diabetes Act of 2010'' or the
``GEDI Act,'' was introduced on May 20, 2010, by Rep. Eliot L.
Engel (D-NY) and referred to the Committee on Energy and
Commerce.
The goal of H.R. 5354 is to expand and intensify research
on gestational diabetes and to provide grants to better
understand and reduce the incidence of this disease.
Background and Need for Legislation
Gestational Diabetes Mellitus (GDM)--generally known as
gestational diabetes--is high blood sugar that starts or is
first diagnosed during pregnancy. According to the Centers for
Disease Control and Prevention (CDC) gestational diabetes
affects between 3% and 7% of all pregnancies in the United
States. It can have negative health effects on both mothers and
their babies--an estimated 40% to 60% of women with gestational
diabetes will develop type 2 diabetes within 10 years; babies
born to mothers with the disease are at risk for having a high
birth weight. Gestational diabetes also disproportionately
affects minority populations.
Gestational diabetes represents less than 1% of the
diabetes burden in the United States, yet its impact on
maternal and child health is significant, and federal support
for research on the disease has been limited. Increased
research is needed to better understand the risk factors for
the disease and to develop evidence-based intervention
strategies.
Committee Consideration
H.R. 5354, the ``Gestational Diabetes Act of 2010'' or the
``GEDI Act,'' was introduced by Mr. Engel of New York on May
20, 2010, and referred to the Committee on Energy and Commerce.
The bill was subsequently referred to the Subcommittee on
Health on May 21, 2010. On September 15, 2010, the Subcommittee
held a legislative hearing on the bill. The Subcommittee met in
open markup session to consider H.R. 5354 on September 16,
2010. An amendment in the nature of a substitute (manager's
amendment) by Mr. Engel was adopted by a voice vote.
Subsequently, H.R. 5354 was favorably forwarded to the full
Committee, amended, by a voice vote.
On September 23, 2010, the Committee on Energy and Commerce
met in open markup session to consider H.R. 5354, as approved
by the Subcommittee on Health. There were no amendments offered
in full Committee and subsequently the Committee ordered H.R.
5354 favorably reported to the House, as amended by the
Subcommittee on Health, by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. A
motion by Mr. Waxman ordering H.R. 5354 reported to the House,
as amended, was approved by a voice vote. There were no record
votes taken during consideration of this bill.
Committee Oversight Findings and Recommendations
In compliance with clause 3(c)(1) of rule XIII and clause
(2)(b)(1) of rule X of the Rules of the House of
Representatives, the oversight findings and recommendations of
the Committee are reflected in the descriptive portions of this
report, including the finding that increased research is needed
to better understand the risk factors for gestational diabetes
and to develop evidence-based intervention strategies.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Regarding compliance with clause 3(c)(2) of rule XIII of
the Rules of the House of Representatives, the Committee finds
that H.R. 5354 would result in no new budget authority,
entitlement authority, or tax expenditures or revenues.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the performance goals and
objectives of the Committee are reflected in the descriptive
portions of this report, including the goal to support
increased research on gestational diabetes.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
constitutional authority for H.R. 5354 is provided under
article I, section 8, clauses 3 and 18 of the Constitution of
the United States.
Earmarks and Tax and Tariff Benefits
H.R. 5354 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
Federal Advisory Committee Statement
The Committee finds that the legislation does not establish
or authorize the establishment of an advisory committee within
the definition of 5 U.S.C. App., section 5(b) of the Federal
Advisory Committee Act.
Applicability of Law to the Legislative Branch
Section 102(b)(3) of Public Law 104-1 requires a
description of the application of this bill to the legislative
branch where the bill relates to terms and conditions of
employment or access to public services and accommodations.
H.R. 5354 contains no such provisions.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act of 1974 (as amended by section 101(a)(2) of the
Unfunded Mandates Reform Act, Public Law 104-4) requires a
statement on whether the provisions of the report include
unfunded mandates. In compliance with this requirement the
Committee adopts as its own the analysis of federal mandates
prepared by the Director of the Congressional Budget Office
regarding H.R. 5354.
Committee Cost Estimate
Pursuant to clause 3(d)(2) of rule XIII of the Rules of the
House of Representatives, the Committee adopts as its own the
cost estimate of H.R. 5354 prepared by the Director of the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
Congressional Budget Office Cost Estimate
With respect to the requirements of clause (3)(c)(3) of
rule XIII of the Rules of the House of Representatives and
section 402 of the Congressional Budget Act of 1974, the
Committee has received the following cost estimate for H.R.
5354 from the Director of Congressional Budget Office:
September 24, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 5354, the
Gestational Diabetes Act of 2010.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Mindy Cohen.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 5354--Gestational Diabetes Act of 2010
Summary: H.R. 5354 would require the Secretary of the
Department of Health and Human Services (HHS) to develop
research projects and award grants for the purposes of tracking
and reducing the prevalence of gestational diabetes. Assuming
appropriation of the specified amounts, CBO estimates that
implementing H.R. 5354 would cost $32 million over the 2011-
2015 period. Enacting H.R. 5354 would not affect direct
spending or revenues; therefore, pay-as-you-go procedures do
not apply.
H.R. 5354 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 5354 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------
2011-
2011 2012 2013 2014 2015 2015
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Authorization Level................................. 0 10 10 10 10 40
Estimated Outlays................................... 0 4 8 10 10 32
----------------------------------------------------------------------------------------------------------------
Basis of estimate: H.R. 5354 would require the Secretary of
HHS, acting through the Director of the Center for Disease
Control and Prevention (CDC), to conduct research and grant
activities relating to gestational diabetes. For example, the
bill would require CDC to expand surveillance data and public
health research, to test approaches for screening for the
disease, and to award grants to entities that implement
interventions to reduce the incidence of the disease.
H.R. 5354 would authorize appropriations for fiscal years
2012 through 2016 of $5 million a year for the research
activities and $5 million a year for the grant activities.
Based on historical spending patterns for similar activities,
and assuming appropriation of the specified amounts, CBO
estimates that implementing H.R. 5354 would cost $32 million
over the 2012-2015 period, and an additional $18 million after
2015.
Pay-As-You-Go considerations: None.
Intergovernmental and private-sector impact: H.R. 5354
contains no intergovernmental or private-sector mandates as
defined in UMRA. Grant funds authorized in the bill would
benefit states that implement programs to reduce the incidence
of gestational diabetes.
Estimate prepared by: Federal costs: Mindy Cohen; Impact on
state, local, and tribal governments: Lisa Ramirez-Branum;
Impact on the private sector: Sarah Axeen.
Estimate approved by: Holly Harvey, Deputy Assistant
Director for Budget Analysis.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the short title may be cited as
the ``Gestational Diabetes Act of 2010'' or the ``GEDI Act.''
Section 2. Gestational Diabetes
Section 2 establishes a new section 317H-1 in the Public
Health Service Act (PHSA) on gestational diabetes. This section
includes the following provisions:
Subsection (a) requires the Secretary of Health and Human
Services (HHS), acting through the Director of the Centers for
Disease Control and Prevention (CDC), and in consultation with
the HHS Diabetes Mellitus Interagency Coordinating Committee
(DMICC) (established under section 429 of the Public Health
Service Act), to develop a multisite, gestational diabetes
research project at CDC to expand and enhance surveillance data
and public health research on gestational diabetes.
Subsection (b) requires the Secretary to expand and
intensify public health research on gestational diabetes
research. Such research may include (1) the development and
testing of new approaches for improving postpartum diabetes
screening and for preventing type 2 diabetes in women with a
history of gestational diabetes; and (2) research to further
understand various factors that influence the risk of
gestational diabetes and the development of type 2 diabetes in
women with a history of gestational diabetes. The Act
authorizes $5 million to support these research activities in
each of FY2012 through FY2016.
Subsection (c) requires the Secretary, acting through the
CDC Director, to award grants to non-profit organizations or
state or local health agencies for demonstration projects to
support various activities designed to implement evidence-based
interventions to reduce the incidence of gestational diabetes
and its recurrence and to prevent type 2 diabetes after
pregnancy. The Act authorizes $5 million to fund these grants
in each of FY2012 through FY2016.
Subsection (d) requires the Secretary, acting through the
CDC Director, to work with state and tribal-based diabetes
prevention and control programs to encourage postpartum
screenings after a diagnosis of gestational diabetes to reduce
(1) the incidence of gestational diabetes and its recurrence;
and (2) the progression to type 2 diabetes and its related
complications.
Explanation of Amendment
During the Subcommittee on Health markup, Mr. Engel of New
York offered an amendment in the nature of a substitute
(manager's amendment), which was adopted by a voice vote. The
substance of the substitute amendment is reflected in the
section-by-section analysis contained in this report.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italic and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part B--Federal-State Cooperation
* * * * * * *
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.
* * * * * * *