New Government Commission Could Streamline Diabetes Care

Jenni Laidman

July 30, 2012

July 30, 2012 — Two US senators have introduced an act that would ensure a thorough review of the US government's approach to diabetes care, an effort experts hope will ultimately slow the pace of this burgeoning epidemic. Several major medical associations were quick to applaud the bipartisan effort, which came out of the Senate Diabetes Caucus and its cochairs, senators Jeanne Shaheen (D-NH) and Susan Collins (R-Maine).

If approved, the National Diabetes Clinical Care Commission Act will create a public–private sector commission to recommend improvements to care.

"This is a fabulous idea when it comes to diabetes," Joan Salge Blake, RD, LDN, a spokesperson for the Academy of Nutrition and Dietetics, said to Medscape Medical News. "Prevention is key, it's absolutely key. Diabetes is the number 7 killer of Americans, and it's something we have a good chance of preventing. But more and more Americans are getting diabetes, and so many issues go along with it, kidney problems, eyesight issues, so many other health issues."

The Juvenile Diabetes Research Foundation (JDRF) also supports the commission formation. "As [the] national cost of diabetes [continues] to rise, it makes sense to ensure federal resources for diabetes care are leveraged most effectively and efforts are well coordinated so that patients receive the best possible care," Cynthia Rice, vice president, government relations, for JDRF said in an email to Medscape Medical News.

"There is a recognition in the diabetes community that continuation of the status quo is unacceptable," Alan Garber, MD, PhD, president of the American Association of Clinical Endocrinologists (AACE), said in a news release. "Doing nothing or even doing more of the same will not reverse the arc of worsening diabetes prevalence and complications which will ultimately overwhelm the entire healthcare system with devastating numbers of patients with this disease alone."

The National Diabetes Clinical Care Commission Act was introduced in September in the US House of Representatives and today has 26 cosponsors, including members of the Physician Caucus.

Under the Senate bill, the National Diabetes Clinical Care Commission will include healthcare professionals who work with patients with diabetes, as well as patient advocates and representatives of federal agencies involved with diabetes care. The group is to make recommendations to the US Secretary of Health and Human Services and to Congress.

The act is endorsed by the major diabetes organizations, including the Pediatric Endocrine Society, the Endocrine Society, the American Academy of Ophthalmology, and the American Diabetes Association, in addition to the AACE and JDRF.

The number of patients with type 2 diabetes in the United States has been growing unchecked in recent decades, roughly at pace with increasing obesity. The US Centers for Disease Control and Prevention (CDC) predicts that 1 in 3 children born in 2000 will develop the disease in their lifetime. Some 26 million Americans have diabetes today, the CDC says, and another 79 million have prediabetes, which greatly predisposes them to developing the disease. In the last 3 years alone, the number of people diagnosed with diabetes jumped by 2 million, and the number with prediabetes grew by 22 million, the CDC says.

In addition, data from the CDC and National Institutes of Health show that incidence of type 1 diabetes also is rising rapidly among youth, with a 23% increase from 2001 to 2009, JDRF's Rice wrote in her email.

Diabetes care costs the United States $174 billion per year, including a third of all Medicare spending.

"AACE believes the National Diabetes Clinical Care Commission is a significant first step in the nation's battle against diabetes and its consequences," Dr. Garber said in a news release.

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