Diabetes Epidemic Grows as Feds Reduce Commitment to Prevention

Year in Review: Congress to Adjourn by Making First-Ever Reduction to Effective CDC Diabetes Prevention Program; Research at NIH Also Cut.

The fiscal year 2006 appropriations bill Congress passed last week contains cuts to critical diabetes prevention efforts at the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The CDC’s Division of Diabetes Translation — which works with local communities to help those suffering from diabetes better control the disease and those at risk for diabetes prevent or delay its onset — is funded at $300,000 less than the previous fiscal year’s budget level. This is the first time the Division of Diabetes Translation has been cut, and it comes on the heels of a newly released CDC study that found that diabetes has risen by over 14 percent in the last two years. The CDC estimates that 20.8 million Americans — 7 percent of the U.S. population — now have diabetes, up from 18.2 million in 2003. As part of the FY06 Labor, Health and Human Services and Education Appropriations Act, Congress also slashed funding for the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), an NIH research division. NIDDK will be funded at $9 million less than last year.

The budget cuts cap a year in which the federal commitment to diabetes prevention lagged behind the increase in diabetes prevalence. This week, Congress also is set to make substantive changes to Medicaid, which will make it much more difficult for beneficiaries with diabetes to access the critical care services, supplies, and medication they need to control the disease.

Additionally, Congress will adjourn without passing stem cell research legislation that would expand and accelerate the research that holds much promise for a cure and better prevention treatment options for diabetes. The diabetes community is a strong supporter of the Stem Cell Research Enhancement Act (S.471/H.R. 810), which earlier this year passed the U.S. House of Representatives with broad bipartisan support and currently awaits a vote in the U.S. Senate. The Association had hoped the Senate would send the bill to the President this year, but now urges the Senate to consider it early next year.

"The 20.8 million Americans with diabetes — and the millions more who care for them and are touched by the disease — deserve better from our government," said Robert A. Rizza, MD, President of the American Diabetes Association. "Instead of increasing our investment in prevention research efforts, Congress has taken the extraordinary step of cutting CDC and NIH funding.

Instead of making it easier for people with diabetes to access life- saving health coverage, Congress is set to approve changes to Medicaid that will do significant harm to beneficiaries with diabetes. Instead of finally passing stem cell legislation that will accelerate the search for better treatments and a cure for diabetes, Congress has opted for inaction."

The CDC’s Division of Diabetes Translation (DDT) runs state-based Diabetes Prevention and Control Programs, which take medical research — such as that sponsored by NIH — and translates it into practices and programs that can be used in local communities. These programs help those currently suffering from diabetes better control and manage the disease and also help those at risk for diabetes prevent or delay its onset. Unfortunately, current funding levels only allow the DDT to provide full support — implementation of awareness and education programs — in 28 states. Because of the decreased funding, the DDT will only be able to conduct surveillance programs in 22 states. While the conference report containing funding for CDC included a minimal .05 percent increase over FY05 for the DDT — because of a one percent across the board cut in non-defense discretionary spending included in the Defense Appropriations Act — the program will receive $63.1 million in FY06, down from $63.4 million in FY05.

The ADA has also been a strong advocate for efforts that help to ensure that Americans with diabetes have access to health care that enables them to properly manage and control the disease. Having access to preventive care, more intensive diabetes management, and diabetes tools helps prevent the serious complications associated with diabetes, while simultaneously saving the U.S. health care system billions of dollars in long-term costs. Consequently, the Association has fought cuts and changes to Medicaid that would leave patients without the tools and supplies they need. The changes to Medicaid contained in the budget reconciliation will dramatically weaken the health coverage of Medicaid beneficiaries.

"It is increasingly vital that we match the rise in diabetes prevalence with a commitment to diabetes research and prevention," said Dr. Rizza. "This year, the federal response not only failed to keep up with the growing diabetes epidemic, but in fact took a few critical steps back. The American Diabetes Association urges Congress and the Administration to resolve in 2006 to act forcefully to improve the federal investment in diabetes research, prevention, and care."

Diabetes is one of this nation’s most prevalent, debilitating, deadly and costly diseases. The CDC recently estimated that 20.8 million Americans live with diabetes, meaning that there are approximately 50,115 people living with diabetes in every Congressional District. One-third of diabetes instances are undiagnosed. The cost of diabetes in America in 2002 was at least $132 billion.

SOURCE American Diabetes Association