What Is The Diabetes Self-Management Training and Education Act?

Diabetes is becoming a major health concern in the United States. The numbers of those at risk for the disease (pre-diabetics) is growing as the population grows increasingly overweight. The number of those already suffering from the disease and its aftereffects is huge. Starting in 1997, Congress attempted to pass legislation to increase education for self-management of diabetes. In successive Congresses, additional bills were introduced for this purpose.

History

• Earlier bills with similar purposes in Congress go back as far as 1997. The first was the Medicare Diabetes Education and Supplies Amendments of 1997. On September 25, 2003, Representatives Weldon and DeGette introduced the Diabetes Self-Management Training Act of 2003 (H.R. 3194). The last action on that bill was on October 6, 2003, when it was referred to the Subcommittee on Health, where it died. Another bill, this time titled the Diabetes Self-Management Training Act of 2005, was introduced in the Senate (S. 626) and in the House of Representatives (H.R. 3612). It was referred to the Committee on Finance and died there. The current bill is the Medicare Diabetes Self-Management Training Act of 2007 (H.R. 4218). It was referred to the Ways and Means Committee on November 15, 2007.

Significance

• Diabetes is recognized by health experts as one of the most serious medical concerns in the United States. The U.S. Congress notes that approximately 21,000,000 people in this country currently have diabetes, and another 54,000,000 are pre-diabetic. Diabetes is the sixth leading cause of mortality, and the occurrence of the condition is increasing (see Resources below). The impact on health care costs is staggering. With better education, the chances of developing diabetes may be reduced, saving lives and dollars.

Function

• The original purpose of these intended Acts was to amend the Society Security Act to allow coverage for certified diabetes trainers that provide out-patient medical education to diabetes patients under Medicare Part B. These trainers, to be certified by the National Certification Board of Diabetes Educators, would work with diabetics not only to educate them about the disease, but also to help them cope with the problems of living with it. The main thrust of the legislation is to prevent complications that end in emergency medical care and worsening conditions by teaching people more about managing diabetes.

Features

• Certified trainers must have credentials in a health care area and hands-on experience in training diabetics to manage their disease themselves. These trainers can be nurses, dietitians or even pharmacists, as long as they have the skills to become certified. By teaching non-diabetics who might be at risk for developing Type II diabetes, it is hoped that changes in lifestyle will prevent further serious conditions. For those already living with the disease, better education will, in many cases, enable them to control their diabetes.

Benefits

• With better control of and reduction of the occurrence of diabetes, Congress estimates that blindness caused by the disease may be reduced by as much as 90 percent. Amputations caused by the vascular complications of diabetes could be reduced by 85 percent, and cardiovascular complications (strokes, heart attacks) could be cut by 50 percent. There are an estimated 20,000 certified diabetes educators in the United States who provide this training.