Background

Diabetes is one of the major drivers of health care spending and utilization in the U.S. The high and growing cost of this disease has become a social and economic burden on the nation and requires immediate action. The creation of a National Diabetes Coordinator would be a positive step in addressing the toll diabetes is having on Americans’ health.

Why Diabetes Needs Federal Leadership

• Diabetes is the fifth-deadliest disease in the U.S.¹
• 23.6 million people have diabetes.²
• More than 40% of adults ages 20 and older have either diabetes or pre-diabetes.³
• By 2025, it is estimated 50 million people will be living with diabetes.⁴
• 1 in 3 boys and 2 in 5 girls born in 2000 are at risk to develop diabetes in their lifetime.⁵
• People with diabetes are at significant risk for serious and costly complications, such as heart disease, stroke, kidney disease or damage to the eyes that can lead to blindness.⁶

The Cost of Diabetes

• In 2007, the direct and indirect economic costs of diabetes were an estimated $174 billion.
• A new study, commissioned by the National Changing Diabetes® Program, added to this existing estimate the costs for undiagnosed diabetes, pre-diabetes and gestational diabetes to bring the total to $218 billion in 2007.

Why Do We Need a National Diabetes Coordinator?

In 2007, NCDP commissioned Mathematica Policy Research, Inc. to identify the range and kinds of federal programs, authority and funding that may influence the incidence, prevalence, treatment and progression of diabetes.⁷

The results of the report showed that there is a lack of effective, coordinated federal leadership and spending in diabetes prevention, treatment and care.

Key findings from the study include:

• In 2005, the federal government spent nearly $80 billion to treat and care for people with diabetes and its complications, accounting for roughly 1 in every 8 dollars - 12 percent - of total federal health care spending.
• Of the $80 billion, only about $4 billion was spent on disease prevention and health promotion activities likely to affect diabetes and just $20 million was exclusively focused on diabetes.
Eighteen out of 21 government agencies have programs that impact diabetes, with a lack of alignment and coordination across agencies.

National Diabetes Coordinator Legislation

Based on these findings, NCDP and its partners issued a series of recommendations for improving federal leadership for diabetes. The principal recommendation was the creation of a National Diabetes Coordinator to ensure coordination of diabetes efforts across all federal agencies.

About 35 years ago, Congress acknowledged the need for diabetes coordination by passing the National Diabetes Act of 1974. However, that law must to be updated to meet the challenges of today’s diabetes crisis – and the best way to do that is through a National Diabetes Coordinator.

We are calling for Congress and the Obama Administration to create a National Diabetes Coordinator, a new leadership position to coordinate and align efforts regarding diabetes across all federal agencies. This position would:

• Be filled by a nationally recognized individual with experience in diabetes
• Work within the Department of Health and Human Services and serve as a principal advisor to the Secretary and President on ways to save lives, money and improve the quality of life for patients by reducing the rates of diabetes and its costly complications.
• Be given specific responsibilities and authority to utilize and coordinate assets within the federal government to ensure that progress is made to prevent and reduce instances of diabetes.

To date, among the organizations that have voiced their support for creating a National Diabetes Coordinator are: the American Diabetes Association, American Academy of Family Physicians, American Association of Diabetes Educators, American Association of Clinical Endocrinologists, American Optometric Association, American Society of Transplantation, Center for Health Transformation, National Association of School Nurses, Endocrine Society and many others.

Click the “Coordinator Support” link on the side bar to see what these and other organizations are saying about why we need a National Diabetes Coordinator.

States Recognize the Need

In addition to federal action, 8 states (TN, NY, FL, GA, VA, SC, MS and KY) have passed or are considering proposals to create a state-level Diabetes Coordinator position to ensure coordination across all state-administered programs.

¹ Kung, Hsiang-Ching, et al. “Deaths: Final Data for 2005,” National Vital Statistics Reports. Volume 56, Number 10. April 24, 2008.
² “All About Diabetes.” American Diabetes Association. n.d. 20 April 2009.
³ Catherine Cowie, et al, “Full Accounting of Diabetes and Pre-Diabetes in the U.S. Populations in 1988-1994 and 2005-2006,” Diabetes Care, Vo. 32, No. 2, February 2009, pg. 290
⁴ “Diabetes & 2025: Four Future Scenarios for the Twin Health Epidemics.” The Institute for Alternative, June 2006.
⁵ Venkat Narayan, K.M., et al, “Lifetime Risk for Diabetes Mellitus in the United States,” Journal of the American Medical Association. Oct 2003; 290; 1884-1890.
⁶ “Complications of Diabetes in the United States.” American Diabetes Association. n.d. 20. April 2009
⁷ http://www.ncdp.com/downloads/fedSpendRpt/FederalSpendingReport_6-6-07.pdf