I 

115TH CONGRESS 

2D SESSION H. R. 5423 

To provide grants to better understand and reduce gestational diabetes, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 2, 2018 

Mr. ENGEL (for himself, Mr. GRIJALVA, Ms. MCCOLLUM, Ms. ROYBALALLARD, and Mr. POCAN) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To provide grants to better understand and reduce 

gestational diabetes, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Gestational Diabetes 

5 Act of 2018’’ or the ‘‘GEDI Act’’. 

6 SEC. 2. GESTATIONAL DIABETES. 

7 Part B of title III of the Public Health Service Act 

8 (42 U.S.C. 243 et seq.) is amended by inserting after sec9 tion 317H the following: 


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1 ‘‘SEC. 317H–1. GESTATIONAL DIABETES. 

2 ‘‘(a) UNDERSTANDING AND MONITORING GESTA3 TIONAL DIABETES.— 

4 ‘‘(1) IN GENERAL.—The Secretary, acting 

5 through the Director of the Centers for Disease 

6 Control and Prevention, in consultation with the Di7 abetes Mellitus Interagency Coordinating Committee 

8 established under section 429 and representatives of 

9 appropriate national health organizations, shall de10 velop a multisite gestational diabetes research 

11 project within the diabetes program of the Centers 

12 for Disease Control and Prevention to expand and 

13 enhance surveillance data and public health research 

14 on gestational diabetes. 

15 ‘‘(2) AREAS TO BE ADDRESSED.—The research 

16 project developed under paragraph (1) shall ad17 dress— 

18 ‘‘(A) procedures to establish accurate and 

19 efficient systems for the collection of gestational 

20 diabetes data within each State and common21 wealth, territory, or possession of the United 

22 States; 

23 ‘‘(B) the progress of collaborative activities 

24 with the National Vital Statistics System, the 

25 National Center for Health Statistics, and 

26 State health departments with respect to the 


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1 standard birth certificate, in order to improve 

2 surveillance of gestational diabetes; 

3 ‘‘(C) postpartum methods of tracking 

4 women with gestational diabetes after delivery 

5 as well as targeted interventions proven to 

6 lower the incidence of type 2 diabetes in that 

7 population; 

8 ‘‘(D) variations in the distribution of diag9 nosed and undiagnosed gestational diabetes, 

10 and of impaired fasting glucose tolerance and 

11 impaired fasting glucose, within and among 

12 groups of women; and 

13 ‘‘(E) factors and culturally sensitive inter14 ventions that influence risks and reduce the in15 cidence of gestational diabetes and related com16 plications during childbirth, including cultural, 

17 behavioral, racial, ethnic, geographic, demo18 graphic, socioeconomic, and genetic factors. 

19 ‘‘(3) REPORT.—Not later than 2 years after the 

20 date of the enactment of this section, and annually 

21 thereafter, the Secretary shall generate a report on 

22 the findings and recommendations of the research 

23 project including prevalence of gestational diabetes 

24 in the multisite area and disseminate the report to 

25 the appropriate Federal and non-Federal agencies. 


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1 ‘‘(b) EXPANSION OF GESTATIONAL DIABETES RE2 SEARCH.— 

3 ‘‘(1) IN GENERAL.—The Secretary shall expand 

4 and intensify public health research regarding gesta5 tional diabetes. Such research may include— 

6 ‘‘(A) developing and testing novel ap7 proaches for improving postpartum diabetes 

8 testing or screening and for preventing type 2 

9 diabetes in women with a history of gestational 

10 diabetes; and 

11 ‘‘(B) conducting public health research to 

12 further understanding of the epidemiologic, 

13 socioenvironmental, behavioral, translation, and 

14 biomedical factors and health systems that in15 fluence the risk of gestational diabetes and the 

16 development of type 2 diabetes in women with 

17 a history of gestational diabetes. 

18 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

19 There is authorized to be appropriated to carry out 

20 this subsection $5,000,000 for each of fiscal years 

21 2019 through 2023. 

22 ‘‘(c) DEMONSTRATION GRANTS TO LOWER THE

23 RATE OF GESTATIONAL DIABETES.— 

24 ‘‘(1) IN GENERAL.—The Secretary, acting 

25 through the Director of the Centers for Disease 


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1 Control and Prevention, shall award grants, on a 

2 competitive basis, to eligible entities for demonstra3 tion projects that implement evidence-based inter4 ventions to reduce the incidence of gestational diabe5 tes, the recurrence of gestational diabetes in subse6 quent pregnancies, and the development of type 2 di7 abetes in women with a history of gestational diabe8 tes. 

9 ‘‘(2) PRIORITY.—In making grants under this 

10 subsection, the Secretary shall give priority to 

11 projects focusing on— 

12 ‘‘(A) helping women who have 1 or more 

13 risk factors for developing gestational diabetes; 

14 ‘‘(B) working with women with a history of 

15 gestational diabetes during a previous preg16 nancy; 

17 ‘‘(C) providing postpartum care for women 

18 with gestational diabetes; 

19 ‘‘(D) tracking cases where women with a 

20 history of gestational diabetes developed type 2 

21 diabetes; 

22 ‘‘(E) educating mothers with a history of 

23 gestational diabetes about the increased risk of 

24 their child developing diabetes; 


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1 ‘‘(F) working to prevent gestational diabe2 tes and prevent or delay the development of 

3 type 2 diabetes in women with a history of ges4 tational diabetes; and 

5 ‘‘(G) achieving outcomes designed to assess 

6 the efficacy and cost-effectiveness of interven7 tions that can inform decisions on long-term 

8 sustainability, including third-party reimburse9 ment. 

10 ‘‘(3) APPLICATION.—An eligible entity desiring 

11 to receive a grant under this subsection shall submit 

12 to the Secretary— 

13 ‘‘(A) an application at such time, in such 

14 manner, and containing such information as the 

15 Secretary may require; and 

16 ‘‘(B) a plan to— 

17 ‘‘(i) lower the rate of gestational dia18 betes during pregnancy; or 

19 ‘‘(ii) develop methods of tracking 

20 women with a history of gestational diabe21 tes and develop effective interventions to 

22 lower the incidence of the recurrence of 

23 gestational diabetes in subsequent preg24 nancies and the development of type 2 dia25 betes. 


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1 ‘‘(4) USES OF FUNDS.—An eligible entity re2 ceiving a grant under this subsection shall use the 

3 grant funds to carry out demonstration projects de4 scribed in paragraph (1), including— 

5 ‘‘(A) expanding community-based health 

6 promotion education, activities, and incentives 

7 focused on the prevention of gestational diabe8 tes and development of type 2 diabetes in 

9 women with a history of gestational diabetes; 

10 ‘‘(B) aiding State- and tribal-based diabe11 tes prevention and control programs to collect, 

12 analyze, disseminate, and report surveillance 

13 data on women with, and at risk for, gesta14 tional diabetes, the recurrence of gestational di15 abetes in subsequent pregnancies, and, for 

16 women with a history of gestational diabetes, 

17 the development of type 2 diabetes; and 

18 ‘‘(C) training and encouraging health care 

19 providers— 

20 ‘‘(i) to promote risk assessment, high21 quality care, and self-management for ges22 tational diabetes and the recurrence of ges23 tational diabetes in subsequent preg24 nancies; and 


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1 ‘‘(ii) to prevent the development of 

2 type 2 diabetes in women with a history of 

3 gestational diabetes, and its complications 

4 in the practice settings of the health care 

5 providers. 

6 ‘‘(5) REPORT.—Not later than 4 years after the 

7 date of the enactment of this section, the Secretary 

8 shall prepare and submit to the Congress a report 

9 concerning the results of the demonstration projects 

10 conducted through the grants awarded under this 

11 subsection. 

12 ‘‘(6) DEFINITION OF ELIGIBLE ENTITY.—In 

13 this subsection, the term ‘eligible entity’ means a 

14 nonprofit organization (such as a nonprofit academic 

15 center or community health center) or a State, trib16 al, or local health agency. 

17 ‘‘(7) AUTHORIZATION OF APPROPRIATIONS.— 

18 There is authorized to be appropriated to carry out 

19 this subsection $5,000,000 for each of fiscal years 

20 2019 through 2023. 

21 ‘‘(d) POSTPARTUM FOLLOW-UP REGARDING GESTA22 TIONAL DIABETES.—The Secretary, acting through the 

23 Director of the Centers for Disease Control and Preven24 tion, shall work with the State- and tribal-based diabetes 

25 prevention and control programs assisted by the Centers 


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1 to encourage postpartum follow-up after gestational diabe2 tes, as medically appropriate, for the purpose of reducing 

3 the incidence of gestational diabetes, the recurrence of 

4 gestational diabetes in subsequent pregnancies, the devel5 opment of type 2 diabetes in women with a history of ges6 tational diabetes, and related complications.’’. 

Æ 


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