Diabetes Educators and Their Supporters Asked to Rally Behind “Catalyst to Better Diabetes Care Act”

Representative Zach Space hopes his “Catalyst to Better Diabetes Care Act of 2009” will catalyze change in the care and treatment of diabetes in the United States. AADE hopes it will reinvigorate the diabetes education movement.

May 8, 2009

Diabetes educators and their supporters nationwide are being asked to rally behind congressional legislation that would establish a "national diabetes report card," promote better training of doctors with regard to reporting diabetes as a factor in births and deaths, and set federal standards requiring doctors to achieve a level of diabetes education before they can be licensed or certified.

Representative Zach Space (D-Ohio) recently reintroduced H.R. 1402, "The Catalyst to Better Diabetes Care Act of 2009," which he described as intended "to catalyze change in the care and treatment of diabetes in the United States." The bill has drawn official support from the American Association of Diabetes Educators, which is hoping that it will reinvigorate the diabetes education movement.

In recent years, funding for diabetes education, including coverage by health insurance plans and HMOs, has not kept pace with the growth of diabetes as a major U.S. health problem.  An estimated 23.6 million Americans had the disease in 2007-7.8 percent of the U.S. population-and another estimated 5.7 million Americans currently are undiagnosed.

Diabetes educators often serve as both teachers and advocates, assisting newly diagnosed diabetes patients with setting up and adhering to diet and lifestyle changes and in many cases acting as go-betweens with doctors and patients.

H.R. 1402 has five major provisions that would affect the level of diabetes education:

  1. The bill would establish a more coordinated outreach among federal agencies to screen seniors who have not been tested for diabetes or pre-diabetes. Government agencies would also try to more closely align their outreach efforts with private and non-profit entities that are also combating diabetes.
  2. It would set up a federal/private sector/non-profit advisory group to find and disseminate the best practices of employee wellness programs that are successfully improving quality of life and saving money for workers with diabetes.
  3. It would create a "national diabetes report card" that every two years would provide the following data or information on trends, available on the Internet:
    • Preventive care practices and quality of care
    • Diabetes risk factors
    • Outcomes
    • National and state-by-state tracking of progress toward diabetes treatment and tracking goals
  4. It would train doctors on the importance of collecting data on diabetes and other chronic diseases for inclusion on birth and death certificates. At the same time, states would be encouraged to adopt the latest revisions in birth and death certificate contents to include those data. The Secretary of Health and Human Services would be encouraged to call for the addition of a question asking whomever certifies a death certificate whether the deceased had diabetes.
    According to the Centers for Disease Control and Prevention, death certificate numbers in 2007 indicate that diabetes contributed to 284,000 deaths. However, diabetes is probably seriously underreported because studies have found that only 35 to 40 percent of decedents with diabetes have diabetes listed anywhere on their death certificate, and only 10 to 15 percent have it listed as the underlying cause of death.
  5. The bill would direct the Secretary of Health and Human Services, in collaboration with the Institute of Medicine and other groups, to study what level of diabetes education should be required before a doctor can be licensed, certified, or recertified. The bill calls for this study to be presented to Congress no more than two years after passage of H.R. 1402.
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Posted by shosty on 12 May 2009

I think it would be helpful to be scrupulous in using the terms "type 1" and "type 2" in every article written about diabetes. Misconceptions about type 1, particularly about lifestyle factors as a cause, abound and can cause a lot of misunderstandings and pain for patients.

Posted by rosiolady on 12 May 2009

I agree it would be VERY helpful to distinguish between type 1 and type 2. In fact, I think there should be an entirely different name assigned to each type, because doctors in general, as well as the general public, don't understand or don't appreciate the difference between the two. I don't quite understand why reporting diabetes statistics is given such importance in the Bill, but I sure wish all medical services providers knew a little more about diabetes. For example, I recently had an infected tooth pulled at a dental school. The instructor demanded that I drink 6 oz. of orange juice so that I wouldn't go too low during the procedure even though my BG meter demonstrated right before his eyes that my BG was already high (due to stress from the infection). This is rank ignorance. The student, who was diabetic and wore an insulin pump himself, as I do, told me to just go ahead and drink it because that instructor wouldn't allow treatment until I did. And I've run into this kind of rank stupidity in hospital settings many times too in my 38 years of type 1 diabetes. Dentists, doctors, nurses--all need to know at least the basics of diabetes!

Posted by Jerry1423 on 12 May 2009

As far as the proposed government act to help with diabetes education ...
I really don't think that this topic has anything to do with what the job of our government is. I really have no idea why the people of government think that they know better than the people outside of government.
Experience shows that when government steps their feet into something things turn bad, and this will be no exception.
Please Zach Space, go find something better to do with you time.

Posted by Anonymous on 14 May 2009

I am 68 and was diagnosed with type 1 diabetes 65 years ago. Type 1's should be called Diabetic. Type 2's should be called twodiabetic. It's a different disease. I have watched diabetic care slowly deterioate
since 1981. Today, type ones are nearly always treated incorrectly by nearly all doctors or care givers of any sort.
The medical profession before 1981 was trained in Type one care & realized that Type one effects everything. Doctors have almost become dangerous because they aren't receiving proper education in the matter.

Posted by Anonymous on 15 May 2009

I do work for the VA which is part of the government. As an RD, CDE. All our veterans can get diabetes education. We could save so much money in medications and amputations, dialysis etc if everyone even had the basic eduation about how the drugs work and timing, diet, carbohydrates, foot care etc. Most doctors do not know this. Here, they can refer to us. Most private doctors either don't refer or patients' insurance covers very poorly. Two diabetes education visits could save thousands of dollars in medications! I agree there is a lot of government waste, but some aspects of the government are good. Don't throw the baby out with the bathwater!

Posted by seashore on 15 May 2009

Diabetes educators should stop following the poor guidance of the American Diabetes Association (ADA), which recommends 5 to 7 times the ideal carb limit (30 grams/day). The ADA insists that a peak blood glucose reading of 180 mg/dL is OK, whereas the International Diabetes Federation (IDF) reported in Sept 2007 that diabetic complications occur when blood glucose exceeds 140 mg/dL. The advice provided by most diabetic educators is making diabetes worse.

Posted by Jerry1423 on 18 May 2009

Seashore ... you have no idea what you are talking about, do you?

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