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Letter to Rep. Nancy Pelosi, Speaker of the House of Representatives and Rep. Kevin McCarthy, House Minority Leader - 378 members of Congress urge House leaders to continue funding special diabetes research program

Letter

By: Liz Cheney, Carol Miller, Alex Mooney, David McKinley, Mike Gallagher, Sean Duffy, Glenn Grothman, Jim Sensenbrenner, Jr., Gwen Moore, Ron Kind, Mark Pocan, Bryan Steil, Denny Heck, Adam Smith, Kim Schrier, Pramila Jayapal, Derek Kilmer, Cathy McMorris Rodgers, Dan Newhouse, Jaime Herrera Beutler, Rick Larsen, Suzan DelBene, Peter Welch, Gerry Connolly, Jennifer Wexton, Don Beyer, Jr., Abigail Spanberger, Denver Riggleman III, Donald McEachin, Bobby Scott, Elaine Luria, Rob Wittman, Ben McAdams, John Curtis, Chris Stewart, Rob Bishop, Brian Babin, Lloyd Doggett II, Filemon Vela, Jr., Marc Veasey, Colin Allred, Eddie Johnson, Sylvia Garcia, Michael Burgess, Roger Williams, Kenny Marchant, Will Hurd, Pete Olson, Joaquin Castro, Jodey Arrington, Bill Flores, Veronica Escobar, Randy Weber, Sr., Michael McCaul, Al Green, Kevin Brady, Lizzie Fletcher, Lance Gooden, Dan Crenshaw, Steve Cohen, David Kustoff, John Rose, Jim Cooper, Scott DesJarlais, Chuck Fleischmann, Tim Burchett, Phil Roe, Dusty Johnson, Jim Clyburn, Ralph Norman, Jr., William Timmons, Jeff Duncan, Joe Wilson, Sr., Joe Cunningham, Jim Langevin, David Cicilline, Mike Doyle, Jr., Conor Lamb, Mike Kelly, Jr., GT Thompson, Jr., Guy Reschenthaler, John Joyce, Lloyd Smucker, Scott Perry, Dan Meuser, Matt Cartwright, Susan Wild, Chrissy Houlahan, Mary Scanlon, Madeleine Dean, Dwight Evans, Brendan Boyle, Brian Fitzpatrick, Kurt Schrader, Peter DeFazio, Earl Blumenauer, Greg Walden, Suzanne Bonamici, Kendra Horn, Tom Cole, Frank Lucas, Markwayne Mullin, Kevin Hern, Anthony Gonzalez, Steve Stivers, Dave Joyce, Tim Ryan, Marcia Fudge, Mike Turner, Marcia Kaptur, Bob Gibbs, Bill Johnson, Bob Latta, Joyce Beatty, Brad Wenstrup, Steve Chabot, Chris Collins, Brian Higgins, Joe Morelle, John Katko, Tom Reed II, Anthony Brindisi, Elise Stefanik, Paul Tonko, Antonio Delgado, Sean Maloney, Nita Lowey, Eliot Engel, José Serrano, Alexandria Ocasio-Cortez, Adriano Espaillat, Carolyn Maloney, Max Rose, Jerry Nadler, Yvette Clarke, Hakeem Jeffries, Nydia Velázquez, Grace Meng, Gregory Meeks, Kathleen Rice, Thomas Suozzi, Pete King, Lee Zeldin, Steven Horsford, Susie Lee, Mark Amodei, Dina Titus, Ben Lujan, Jr., Xochitl Torres Small, Deb Haaland, Bonnie Watson Coleman, Mikie Sherrill, Don Payne, Jr., Bill Pascrell, Jr., Albio Sires, Tom Malinowski, Joshua Gottheimer, Andy Kim, Jeff Van Drew, Donald Norcross, Ann Kuster, Chris Pappas, Donald Bacon, Jeff Fortenberry, Kelly Armstrong, Ted Budd, Rosa DeLauro, Joe Courtney, John Larson, Ed Perlmutter, Jason Crow, Doug Lamborn, Ken Buck, Scott Tipton, Joe Neguse, Susan Davis, Scott Peters, Juan Vargas, Duncan Hunter, Mike Levin, Harley Rouda, Alan Lowenthal, Lou Correa, Katie Porter, Nanette Barragán, Maxine Waters, Ken Calvert, Mark Takano, Lucille Roybal-Allard, Gil Cisneros, Linda Sánchez, Karen Bass, Raul Ruiz, Jimmy Gomez, Ted Lieu, Grace Napolitano, Pete Aguilar, Brad Sherman, Tony Cárdenas, Adam Schiff, Judy Chu, Julia Brownley, Katie Hill, Salud Carbajal, T. J. Cox, Jimmy Panetta, Zoe Lofgren, Ro Khanna, Jim Costa, Eric Swalwell, Alma Adams, Mark Meadows, Patrick McHenry, David Rouzer, Mark Walker, David Price, George Holding, G.K. Butterfield, Jr., Greg Gianforte, Steven Palazzo, Michael Guest, Bennie Thompson, Trent Kelly, Kilili Sablan, Jason Smith, Billy Long, Sam Graves, Emanuel Cleaver II, Vicky Hartzler, Blaine Luetkemeyer, Ann Wagner, Lacy Clay, Jr., Peter Stauber, Collin Peterson, Tom Emmer, Ilhan Omar, Betty McCollum, Dean Phillips, Angie Craig, Jim Hagedorn, Brenda Lawrence, Rashida Tlaib, Debbie Dingell, Haley Stevens, Paul Mitchell, Andy Levin, Elissa Slotkin, Tim Walberg, Fred Upton, Dan Kildee, John Moolenaar, Jack Bergman, Jared Golden, Chellie Pingree, Jamie Raskin, Elijah Cummings, David Trone, Anthony Brown, John Sarbanes, Dutch Ruppersberger, Bill Keating, Stephen Lynch, Ayanna Pressley, Seth Moulton, Katherine Clark, Joe Kennedy III, Lori Trahan, Jim McGovern, Garret Graves, Ralph Abraham, Cedric Richmond, Steve Scalise, Andy Barr, John Yarmuth, Brett Guthrie, James Comer, Jr., Ron Estes, Sharice Davids, Steven Watkins, Jr., Roger Marshall, Trey Hollingsworth III, Larry Bucshon, André Carson, Susan Brooks, Jim Baird, Jim Banks, Jackie Walorski, Darin LaHood, Cheri Bustos, Adam Kinzinger, John Shimkus, Lauren Underwood, Rodney Davis, Mike Bost, Bill Foster, Brad Schneider, Jan Schakowsky, Raja Krishnamoorthi, Danny Davis, Sean Casten, Mike Quigley, Jesus Garcia, Dan Lipinski, Robin Kelly, Bobby Rush, Mike Simpson, Steve King, Cindy Axne, Dave Loebsack, Abby Finkenauer, Tulsi Gabbard, David Scott, Rick Allen, Austin Scott, Rob Woodall, Lucy McBath, Hank Johnson, Jr., Sanford Bishop, Jr., Buddy Carter, Donna Shalala, Debbie Mucarsel-Powell, Mario Diaz-Balart, Frederica Wilson, Debbie Wasserman Schultz, Ted Deutch, Lois Frankel, Alcee Hastings, Sr., Francis Rooney, Brian Mast, Vern Buchanan, Kathy Castor, Charlie Crist, Jr., Gus Bilirakis, Val Demings, Darren Soto, Bill Posey, Stephanie Murphy, Al Lawson, Jr., John Rutherford, Ted Yoho, Matt Gaetz, Lisa Blunt Rochester, Eleanor Norton, Jahana Hayes, Jim Himes, Jackie Speier, Barbara Lee, Mark DeSaulnier, Josh Harder, Jerry McNerney, Paul Cook, Ami Bera, Doris Matsui, Mike Thompson, John Garamendi, Jared Huffman, Doug LaMalfa, Greg Stanton, Debbie Lesko, Ruben Gallego, David Schweikert, Raul Grijalva, Ann Kirkpatrick, Tom O'Halleran, Aumua Amata Radewagen, Bruce Westerman, Steve Womack, French Hill, Rick Crawford, Terri Sewell, Gary Palmer, Robert Aderholt, Mike Rogers, Martha Roby, Bradley Byrne, Donald Young, Diana DeGette
Date: May 9, 2019
Location: Washington, DC

Dear Speaker Pelosi and Republican Leader McCarthy:

We write today to thank you for your strong and steadfast support of the Special Diabetes Program and ask for your commitment to reauthorize the program prior to the expiration of its current authorization in September 2019. The Special Diabetes Program is comprised of two important components: the Special Statutory Funding Program for Type 1 Diabetes Research (SDP) and the Special Diabetes Program for Indians (SDPI). Without question, the lives of roughly 30.3 million individuals with diabetes, 84.1 million with prediabetes, and countless families impacted by the disease have benefited from these critical programs. It is essential that we continue to invest in the research necessary to develop a cure for diabetes, as well as support the programs that help prevent and treat the disease and its complications.

Diabetes is our country's most costly disease in both human and economic terms, affecting people of all ages, races, and in every region of our country. It is the number one cause of kidney disease, blindness in working-age adults, and lower-limb amputations. In addition, it is a leading cause of heart disease and stroke. Approximately one in four health care dollars and one in three Medicare dollars are spent treating people with diabetes. The total cost of diagnosed diabetes in the United States in 2017 was $327 billion, with $237 billion for direct medical costs and another $90 billion due to reduced productivity. Medical expenditures for individuals diagnosed with diabetes are roughly 2.3 times higher than expenditures for those without the disease.

Overall, the economic costs of diabetes, adjusted for inflation, increased by 26 percent from 2012 to 2017, and these costs are expected to increase as the number of people with diabetes continues to grow. According to the Centers for Disease Control and Prevention's 2017 National Diabetes Statistics Report, an estimated 1.5 million new cases of diabetes (6.7 per 1,000 persons) were diagnosed among U.S. adults in 2015.

While the increase in these statistics is very concerning, the SDP is making meaningful progress. SDP funds research that is leading directly to the development of new insights and therapies that are improving the lives of those with diabetes and accelerating progress towards curing and preventing the disease. Likewise, the SDPI is having a significant and positive impact on the health of American Indians and Alaska Natives (AI/AN), who are disproportionately affected by type 2 diabetes. The SDPI is making it possible to develop and sustain quality diabetes treatment and prevention programs in AI/AN communities where they are most needed.

Some notable developments from SDP and SDPI include:

Artificial Pancreas (AP) Systems: SDP-funded research greatly accelerated the development of AP systems, which have shown the ability to reduce costly and burdensome type 1 diabetes (T1D) complications and improve the quality of life for those with the disease. SDP funds led to the first fully automated insulin-dosing system being made available to patients in 2017, some 5 to 7 years earlier than expected. Multiple other AP systems are being tested in outpatient trials. According to one study, the use of AP systems in adults could save Medicare roughly $1 billion over 25 years.

Kidney Disease: Researchers have discovered that 6.5 years of intensive blood glucose control can cut in half the onset of impaired kidney function in people with T1D. This reduction in end-stage renal disease could save Medicare roughly $126 billion over 25 years. Kidney disease in AI/AN individuals is also in decline. Between 1996 and 2013, incidence rates of end-stage renal disease (ESRD) in AI/AN individuals with diabetes declined by 54 percent. The decrease in ESRD incidence has resulted in a 29 percent decrease in prevalence of ESRD since 2000, representing the only instance of a decline in adjusted prevalence for a major racial group.

Eye Therapies: SDP-funded research discovered that combining a drug with laser therapy can reverse vision loss in people living with diabetes. The SDP also filled a critical research gap by funding a head-to-head comparison of three drugs for the treatment of diabetic eye disease. The results are helping patients, clinicians, and insurers to identify the right therapy and course of treatment for each individual person. During the SDP era, diabetic eye disease rates have decreased by 50 percent for AI/ANs, resulting in a reduction of vision loss and blindness among AI/AN patients.

Prevention: A truly groundbreaking 15-year study of 8,600 children is currently ongoing to determine what environmental factors influence the onset of T1D. Researchers believe that by identifying specific triggering factors, new strategies can be developed to prevent the initial onset of the disease. Communities with SDPI-funded programs have seen a 54 percent increase in nutrition services, a 72 percent increase in community walking and running programs, a 59 percent increase in adult weight management programs, and a 56 percent increase in weight management for children and youth.

Glucose Control: The average blood sugar level, as measured by the hemoglobin A1C test, decreased from 9.0 percent in 1996 to 8.1 percent in 2014 in the AI/AN population. Every percentage point drop in A1C can reduce the risk of eye, kidney, and nerve complications by up to 40 percent.

Clearly, the SDP and SDPI are improving the lives of the over 114 million Americans living with or at risk of developing diabetes, while also greatly reducing the long-term health care expenditures related to its complications. However, further investment in these vital programs is essential to continue outreach and education, plan next steps for research programs, and effectively allocate resources -- all of which play an important role in helping to better treat, prevent, and ultimately cure diabetes.

Thanks to your leadership, both components of the Special Diabetes Program continue to receive strong bipartisan support. We look forward to working with you to ensure that these programs together remain a beacon of hope for all Americans living with or at risk of diabetes.


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