II 

109TH CONGRESS 

2D SESSION S. 3914 

To establish an Advisory Committee on Gestational Diabetes, to provide 

grants to better understand and reduce gestational diabetes, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 20, 2006 

Mrs. CLINTON (for herself, Ms. COLLINS, and Mrs. LINCOLN) introduced the 

following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To establish an Advisory Committee on Gestational Diabetes, 

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 2006’’ or the ‘‘GEDI Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) The prevalence of gestational diabetes 

2 among pregnant women in the United States is in3 creasing. 

4 (2) Gestational diabetes, which is similar to 

5 chronic forms of diabetes, normally appears at 24 to 

6 28 weeks’ gestation and occurs in approximately 4 

7 to 8 percent of pregnant women. 

8 (3) The causes of gestational diabetes are un9 known, but genetics, excess weight, ethnicity, and 

10 age are considered risk factors for the condition. 

11 (4) There is disagreement among physicians 

12 about how to treat gestational diabetes, as well as 

13 the effectiveness of current treatment regimens. 

14 (5) Gestational diabetes, which can cause 

15 preeclampsia, also increases a pregnant woman’s 

16 risk for developing the condition in subsequent preg17 nancies. 

18 (6) Infants of women who develop gestational 

19 diabetes may have extreme increases in birth weight 

20 and the risks related to difficulties during the birth21 ing process, and some of the infants born to these 

22 women— 

23 (A) may subsequently have low blood sugar 

24 or jaundice during the newborn period; 


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1 (B) are at an increased risk for obesity 

2 and birth trauma; and 

3 (C) are at an increased risk of developing 

4 type 2 diabetes as an adolescent or adult. 

5 (7) About 15 percent of infertility cases are 

6 linked to weight disorders, most often being over7 weight or obese. Obesity affects fertility and is also 

8 associated with increased morbidity for both the 

9 mother and the child. 

10 (8) Improved nutritional and physical health 

11 care, both before and during pregnancy, may signifi12 cantly decrease the rates of gestational diabetes. 

13 (9) Ten percent of obese pregnant women are 

14 estimated to have gestational diabetes. 

15 (10) Obesity potentially leads to a higher rate 

16 of induction and primary caesarean section. 

17 SEC. 3. GESTATIONAL DIABETES. 

18 The Public Health Service Act (42 U.S.C. 201 et 

19 seq.) is amended by adding at the end the following: 


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1 ‘‘TITLE XXIX—GESTATIONAL 

2 DIABETES 

3 ‘‘SEC. 2901. UNDERSTANDING AND MONITORING GESTA4 TIONAL DIABETES AND OBESITY DURING 

5 PREGNANCY. 

6 ‘‘(a) IN GENERAL.—The Secretary of Health and 

7 Human Services, acting through the Director of the Cen8 ters for Disease Control and Prevention, shall convene a 

9 Research Advisory Committee. 

10 ‘‘(b) MEMBERSHIP.—Membership in the Research 

11 Advisory Committee— 

12 ‘‘(1) shall include— 

13 ‘‘(A) a representative from the Agency for 

14 Healthcare Research and Quality; 

15 ‘‘(B) a representative from the Centers for 

16 Disease Control and Prevention; 

17 ‘‘(C) a representative from the National 

18 Institutes of Health; 

19 ‘‘(D) a representative from the Office of 

20 Minority Health; 

21 ‘‘(E) a representative from the Indian 

22 Health Service; and 

23 ‘‘(F) representatives from other appro24 priate Federal agencies; and 


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1 ‘‘(2) may include representatives from other ap2 propriate organizations. 

3 ‘‘(c) MATTERS TO BE STUDIED.—The Director of 

4 the Centers for Disease Control and Prevention, in con5 sultation with the Research Advisory Committee, shall de6 velop a multisite, gestational diabetes research project 

7 within the diabetes program of the Centers for Disease 

8 Control and Prevention to expand and enhance surveil9 lance data and public health research on gestational diabe10 tes. The project shall address— 

11 ‘‘(1) the use of consistent standards to measure 

12 gestational diabetes; 

13 ‘‘(2) the procedures to establish accurate and 

14 efficient systems for the collection of gestational dia15 betes data within each State; 

16 ‘‘(3) the progress of collaborative activities with 

17 the National Vital Statistics System, the National 

18 Center for Health Statistics, and State health de19 partments with respect to the standard birth certifi20 cate, in order to improve surveillance of gestational 

21 diabetes; 

22 ‘‘(4) the establishment of procedures for report23 ing gestational diabetes data to the Centers for Dis24 ease Control and Prevention; 


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1 ‘‘(5) post-natal methods of tracking women who 

2 had gestational diabetes after delivery and the devel3 opment of ways to lower the incidence of type 2 dia4 betes in that population; 

5 ‘‘(6) variations in the distribution of diagnosed 

6 and undiagnosed diabetes and of impaired fasting 

7 glucose tolerance and impaired fasting glucose with8 in and among groups of women; and 

9 ‘‘(7) factors that influence risks for gestational 

10 diabetes and obesity during pregnancy and complica11 tions during childbirth among women, including cul12 tural, racial, ethnic, geographic, demographic, socio13 economic, and genetic factors. 

14 ‘‘(d) MEETINGS.—Not later than 1 year after the es15 tablishment of the gestational diabetes research project 

16 under subsection (c), and annually thereafter, the Re17 search Advisory Committee shall meet to assess the 

18 progress of the project and to update the Secretary of 

19 Health and Human Services, if necessary. 

20 ‘‘(e) REPORT.—Not later than 2 years after the date 

21 of enactment of the Gestational Diabetes Act of 2006, and 

22 annually thereafter, the Director of the Centers for Dis23 ease Control and Prevention shall generate a report on 

24 the prevalence of gestational diabetes and disseminate the 


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1 report to the Secretary of Health and Human Services and 

2 appropriate Federal and non-Federal agencies. 

3 ‘‘SEC. 2902. DEMONSTRATION GRANTS TO LOWER THE RATE 

4 OF GESTATIONAL DIABETES AND OBESITY 

5 DURING PREGNANCY. 

6 ‘‘(a) IN GENERAL.—The Secretary of Health and 

7 Human Services, acting through the Director of the Cen8 ters for Disease Control and Prevention, in consultation 

9 with the Research Advisory Committee established under 

10 section 2901, shall award grants, on a competitive basis, 

11 to eligible entities for demonstration projects that test 

12 specified hypotheses about interventions designed to re13 duce the incidence of gestational diabetes and obesity 

14 among young women and implement relevant activities. In 

15 making such grants, the Director shall act on scientific 

16 findings that— 

17 ‘‘(1) the prevention or delay of type 2 diabetes 

18 is possible for older adults; 

19 ‘‘(2) the diabetes risk status of an individual is 

20 likely established during the individual’s earlier age 

21 (adolescence through the age of 30); 

22 ‘‘(3) women are uniquely capable of dem23 onstrating their diabetes risk status, through acquir24 ing gestational diabetes during the challenge of preg25 nancy; 


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1 ‘‘(4) gestational diabetes itself is a well-estab2 lished risk factor for a woman’s subsequent transi3 tion to type 2 diabetes; and 

4 ‘‘(5) gestational diabetes may confer risks of fu5 ture obesity and type 2 diabetes on the children of 

6 a mother with gestational diabetes. 

7 ‘‘(b) APPLICATION.—An eligible entity desiring to re8 ceive a grant under this section shall submit to the Direc9 tor of the Centers for Disease Control and Prevention— 

10 ‘‘(1) an application at such time, in such man11 ner, and containing such information as the Director 

12 may require; and 

13 ‘‘(2) a plan to— 

14 ‘‘(A) lower the rate of gestational diabetes 

15 and obesity during pregnancy; or 

16 ‘‘(B) conduct post-natal methods of track17 ing women who had gestational diabetes in 

18 order to develop ways to lower the incidence of 

19 such mothers developing type 2 diabetes. 

20 ‘‘(c) USES OF FUNDS.—An entity receiving a grant 

21 under this section shall use grant funds to carry out dem22 onstration projects, which may include— 

23 ‘‘(1) expanding community-based health pro24 motion education, activities, and incentives focused 


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1 on the prevention of gestational diabetes and obesity 

2 during pregnancy; 

3 ‘‘(2) aiding State-based diabetes prevention and 

4 control programs to collect, analyze, disseminate, 

5 and report surveillance data on women with, and at 

6 risk for, gestational diabetes and obesity during 

7 pregnancy; 

8 ‘‘(3) building capacity with State-based part9 ners to implement programs and interventions based 

10 on surveillance data; and 

11 ‘‘(4) training and encouraging health care pro12 viders to promote risk assessment, quality care, and 

13 self-management for gestational diabetes and obesity 

14 during pregnancy and its complications in the prac15 tice settings of the health care providers. 

16 ‘‘(d) REPORTS.— 

17 ‘‘(1) CDC REPORT.—Not later than 2 years 

18 after the date of enactment of the Gestational Dia19 betes Act of 2006, the Director of the Centers for 

20 Disease Control and Prevention shall prepare and 

21 submit a report to the Secretary of Health and 

22 Human Services concerning the results of the stud23 ies conducted through the grants awarded under this 

24 section. 


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1 ‘‘(2) SECRETARY REPORT.—Not later than 90 

2 days after receiving the report described in para3 graph (1), the Secretary shall prepare and submit a 

4 report to Congress concerning the results and find5 ings of the report. 

6 ‘‘(e) DEFINITION OF ELIGIBLE ENTITY.—In this sec7 tion, the term ‘eligible entity’ means a nonprofit organiza8 tion (such as an academic center or community health cen9 ter) or a State health agency. 

10 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated to carry out this section 

12 $5,000,000 for fiscal year 2007 and such sums as may 

13 be necessary for each of the fiscal years 2008 through 

14 2011. 

15 ‘‘SEC. 2903. RESEARCH EXPANSION OF GESTATIONAL DIA16 BETES AND OBESITY DURING PREGNANCY. 

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

18 Disease Control and Prevention and the Director of the 

19 National Institute of Child Health and Human Develop20 ment, in collaboration with the National Institute of Dia21 betes and Digestive and Kidney Diseases, shall conduct 

22 and support basic, clinical, and public health research re23 garding gestational diabetes and obesity during preg24 nancy. Such research shall include— 


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1 ‘‘(1) investigating therapies, interventions, and 

2 agents to detect, treat, and slow the incidence of, 

3 gestational diabetes and obesity during pregnancy; 

4 ‘‘(2) developing and testing novel approaches to 

5 the design and analysis of clinical trials; 

6 ‘‘(3) facilitating the enrollment of patients for 

7 clinical trials, including patients from diverse popu8 lations and populations who suffer disproportionately 

9 from these conditions; 

10 ‘‘(4) developing improved diagnostics and 

11 means of patient assessment for gestational diabetes 

12 and obesity during pregnancy; and 

13 ‘‘(5) conducting public health research to fur14 ther knowledge on epidemiologic, socioenvironmental, 

15 behavioral, translation, and biomedical factors that 

16 influence gestational diabetes and obesity during 

17 pregnancy. 

18 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

19 are authorized to be appropriated to carry out this section 

20 $8,000,000 for fiscal year 2007 and such sums as may 

21 be necessary for each of the fiscal years 2008 through 

22 2011. 

23 ‘‘SEC. 2904. SCREENING FOR GESTATIONAL DIABETES. 

24 ‘‘The Director of the Centers for Disease Control and 

25 Prevention shall encourage screening for gestational diaVerDate Aug 31 2005 02:42 Sep 21, 2006 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3914.IS S3914

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1 betes within the State-based diabetes prevention and con2 trol programs assisted by the Centers for Disease Control 

3 and Prevention, for the purpose of reducing the incidence 

4 of gestational diabetes and its related complications.’’. 

Æ 


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