II 

110TH CONGRESS 

1ST SESSION S. 1343 

To amend the Public Health Service Act with respect to prevention and 

treatment of diabetes, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 9, 2007 

Mrs. CLINTON (for herself and Ms. COLLINS) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act with respect to 

prevention and treatment of 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 ‘‘Diabetes Treatment 

5 and Prevention Act of 2007’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) According to the Centers for Disease Con9 trol and Prevention, the prevalence of diabetes in the 


ccoleman on PRODPC75 with BILLS
2 

•S 1343 IS

1 United States has more than doubled in the past 

2 quarter-century. 

3 (2) The American Diabetes Association reports 

4 that there are now more than 20,000,000 Americans 

5 living with diabetes, with 6,000,000 of these cases 

6 not yet diagnosed. Another 54,000,000 Americans 

7 have ‘‘pre-diabetes’’, which means that they have 

8 higher than normal blood glucose levels, and are at 

9 increased risk of developing diabetes. 

10 (3) In 2002, the landmark Diabetes Prevention 

11 Program study found that lifestyle changes, such as 

12 diet and exercise, can prevent or delay the onset of 

13 type 2 diabetes, and that participants who made 

14 such lifestyle changes reduced their risk of getting 

15 type 2 diabetes by 58 percent. 

16 (4) The New York Times has reported that life17 style-based interventions to control diabetes have re18 sulted in positive outcomes for patients, yet despite 

19 these successes, such interventions were often 

20 unsustainable. While insurance companies cover the 

21 treatments of complications of unchecked diabetes, 

22 they tend not to cover the cheaper interventions to 

23 prevent such complications. 

24 (5) According to the American Diabetes Asso25 ciation, in 2002, direct medical expenditures for diaVerDate Aug 31 2005 02:46 May 12, 2007 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343

ccoleman on PRODPC75 with BILLS
3 

•S 1343 IS

1 betes totaled $91,800,000,000, including 

2 $23,200,000,000 for diabetes care, and 

3 $24,600,000,000 for chronic complications attrib4 utable to diabetes. In that year, approximately 1 out 

5 of every 10 health care dollars was directed to diabe6 tes. 

7 (6) There is a need to increase the availability 

8 of effective community-based lifestyle programs for 

9 diabetes prevention and the ability of health care 

10 providers to refer patients for enrollment in such 

11 programs to prevent diabetes, reduce complications, 

12 and lower the costs associated with diabetes treat13 ment in the United States, and our Government 

14 should encourage efforts to replicate the results of 

15 the Diabetes Prevention Program on a wider scale. 

16 SEC. 3. CENTERS FOR DISEASE CONTROL AND PREVEN17 TION DIVISION OF DIABETES TRANSLATION; 

18 DIABETES DEMONSTRATION PROJECTS. 

19 Title III of the Public Health Service Act (42 U.S.C. 

20 241 et seq.) is amended by inserting after section 317S 

21 the following: 

22 ‘‘SEC. 317T. CENTERS FOR DISEASE CONTROL AND PREVEN23 TION DIVISION OF DIABETES TRANSLATION. 

24 ‘‘(a) IN GENERAL.—The Director of the Centers for 

25 Disease Control and Prevention shall establish within such 


ccoleman on PRODPC75 with BILLS
4 

•S 1343 IS

1 Centers a Division of Diabetes Translation to eliminate 

2 the preventable burden of diabetes. 

3 ‘‘(b) OFFICE.—The Division of Diabetes Translation 

4 shall carry out the following activities: 

5 ‘‘(1) Supporting and carrying out diabetes sur6 veillance. 

7 ‘‘(2) Conducting applied translational research, 

8 including research that will improve early detection, 

9 prevention, and access to quality care with respect to 

10 diabetes. 

11 ‘‘(3) Working with States to establish and im12 prove diabetes control and prevention programs. 

13 ‘‘(4) Coordinating the National Diabetes Edu14 cation Program in conjunction with the National In15 stitutes of Health. 

16 ‘‘(5) Increasing education and awareness of dia17 betes. 

18 ‘‘(6) Promoting greater awareness of the health 

19 effects of uncontrolled diabetes. 

20 ‘‘(7) Other activities as deemed appropriate by 

21 the Director. 

22 ‘‘(c) APPROPRIATIONS.—There are authorized to be 

23 appropriated to carry out the activities of the Division of 

24 Diabetes Translation under this section $90,000,000 for 


ccoleman on PRODPC75 with BILLS
5 

•S 1343 IS

1 fiscal year 2008, and such sums as may be necessary for 

2 each subsequent fiscal year. 

3 ‘‘SEC. 317U. DEMONSTRATION PROJECTS FOR THE IDENTI4 FICATION AND TREATMENT FOR PERSONS DI5 AGNOSED WITH OR AT HIGH RISK FOR DIABE6 TES. 

7 ‘‘(a) IDENTIFICATION AND PREVENTION DEM8 ONSTRATION PROJECTS FOR PERSONS AT HIGH RISK FOR

9 TYPE 2 DIABETES.— 

10 ‘‘(1) IN GENERAL.— 

11 ‘‘(A) DEVELOPMENT.—The Director of the 

12 Centers for Disease Control and Prevention (re13 ferred to in this section as the ‘Director’), in 

14 consultation with the Division of Diabetes 

15 Translation and academic centers, shall develop 

16 a set of pilot demonstration projects to evaluate 

17 various approaches to— 

18 ‘‘(i) screening and identifying persons 

19 with pre-diabetes and undiagnosed diabe20 tes; and 

21 ‘‘(ii) providing identified persons with 

22 access to appropriate lifestyle interven23 tions. 

24 ‘‘(B) LINKAGE TO DIABETES PREVENTION

25 PROGRAM.—Such pilot projects shall be carried 


ccoleman on PRODPC75 with BILLS
6 

•S 1343 IS

1 out with the goal of translating, using lifestyle 

2 interventions available in the community, the 

3 Diabetes Prevention Program clinical trial into 

4 interventions to reduce the incidence of type 2 

5 diabetes and its related complications in the 

6 United States population. 

7 ‘‘(2) COOPERATIVE AGREEMENTS.— 

8 ‘‘(A) IN GENERAL.—The Director shall 

9 provide cooperative agreements and technical 

10 assistance to not more than 10 academic cen11 ters partnered with State or local public health 

12 departments to implement, monitor, and evalu13 ate such pilot programs. 

14 ‘‘(B) APPLICATION.—Applicants shall sub15 mit to the Director an application, at such time, 

16 in such manner, and containing such informa17 tion as the Director may require, including— 

18 ‘‘(i) information documenting the risk 

19 of the populations to be targeted by this 

20 intervention; and 

21 ‘‘(ii) information regarding the meth22 ods that shall be used to identify and 

23 screen these populations. 

24 ‘‘(3) DURATION.—The cooperative agreements 

25 awarded under this subsection shall be awarded for 


ccoleman on PRODPC75 with BILLS
7 

•S 1343 IS

1 a 2-year period, with the Director having the option 

2 to extend cooperative agreements for an additional 

3 2-year period. 

4 ‘‘(4) EVALUATION.—Not later than 4 years 

5 after date of the enactment of the Diabetes Treat6 ment and Prevention Act of 2007, the Director shall 

7 release a report evaluating the effectiveness of this 

8 program. 

9 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated 

11 $10,000,000 to carry out this subsection for each of 

12 fiscal years 2008 through 2012. 

13 ‘‘(b) STATE PARTNERSHIPS FOR SURVEILLANCE AND

14 EDUCATION.— 

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

16 through the Director of the Centers for Disease 

17 Control and Prevention, shall engage in partnerships 

18 with State and local health departments to carry out 

19 the following activities: 

20 ‘‘(A) National, State, and local (to the de21 gree determined by the Secretary) surveillance 

22 of the following items: 

23 ‘‘(i) The number of individuals and 

24 percentage of the population at risk for de25 veloping diabetes. 


ccoleman on PRODPC75 with BILLS
8 

•S 1343 IS

1 ‘‘(ii) The number of individuals and 

2 percentage of the population who have re3 ceived diabetes and high blood glucose 

4 screenings. 

5 ‘‘(iii) Among those individuals who 

6 have been identified with pre-diabetes, the 

7 proportion that have been enrolled into 

8 lifestyle programs. 

9 ‘‘(iv) The availability of interventions 

10 to prevent diabetes, and the access of the 

11 population to such interventions. 

12 ‘‘(v) The number of individuals and 

13 percentage of population with both newly14 diagnosed cases of diabetes and existing 

15 cases of diabetes, as well as the rates of in16 crease or decrease in newly-diagnosed dia17 betes. 

18 ‘‘(vi) Other relevant factors as deter19 mined by the Secretary. 

20 ‘‘(B) Education and information cam21 paigns to increase awareness among populations 

22 at high risk for diabetes, health care providers, 

23 and the general public, about the importance of 

24 primary prevention, ways to assess personal 


ccoleman on PRODPC75 with BILLS
9 

•S 1343 IS

1 risk, and how to locate and access diabetes pre2 vention programs. 

3 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated 

5 $10,000,000 to carry out this subsection for each of 

6 fiscal year 2008 through 2012. 

7 ‘‘(c) TREATMENT DEMONSTRATION PROJECTS FOR

8 CO-OCCURRING CHRONIC CONDITIONS.— 

9 ‘‘(1) IN GENERAL.—The Director, acting 

10 through the Division of Diabetes Translation, shall 

11 develop a pilot program to improve treatment for in12 dividuals with diabetes and other co-occurring chron13 ic conditions, such as mental illness, high blood pres14 sure, or cardiovascular disease, for which treatment 

15 may complicate the treatment for diabetes. 

16 ‘‘(2) COOPERATIVE AGREEMENTS.— 

17 ‘‘(A) IN GENERAL.—The Director shall 

18 provide cooperative agreements and technical 

19 assistance to not more than 10 academic cen20 ters, in partnership with State and local health 

21 departments, to implement, monitor, and evalu22 ate programs designed to improve health out23 comes in individuals with diabetes and other co24 occurring chronic conditions. 


ccoleman on PRODPC75 with BILLS
10 

•S 1343 IS

1 ‘‘(B) APPLICATION.—Applicants shall sub2 mit to the Director an application, at such time, 

3 in such manner, and containing such informa4 tion as the Director may require, including in5 formation regarding the co-occurring conditions 

6 that shall be the subject of study. 

7 ‘‘(C) PREFERENCE.—In awarding the co8 operative agreements under this subsection, the 

9 Director shall give preference for research that 

10 focuses on conditions which have a high preva11 lence among individuals with diabetes, or for 

12 which the treatment involved has the potential 

13 to impact adherence to diabetes treatment regi14 mens and that builds upon existing work de15 signed to improve the quality of care for pa16 tients with diabetes. 

17 ‘‘(3) DURATION.—The cooperative agreements 

18 awarded under this subsection shall be awarded for 

19 a 2-year period, with the Director having the option 

20 to extend cooperative agreements for an additional 

21 2-year period. 

22 ‘‘(4) EVALUATION.—Not later than 4 years 

23 after the date of enactment of the Diabetes Treat24 ment and Prevention Act of 2007, the Director shall 

25 release a report evaluating the effectiveness of this 


ccoleman on PRODPC75 with BILLS
11 

•S 1343 IS

1 program in improving the health care outcomes for 

2 individuals with diabetes and other co-occurring 

3 chronic conditions. 

4 ‘‘(5) APPROPRIATIONS.—There are authorized 

5 to be appropriated $10,000,000 to carry out this 

6 subsection for each of fiscal years 2008 through 

7 2012.’’. 

Æ 


ccoleman on PRODPC75 with BILLS