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.