Multi-Year Renewal of the Special Diabetes Program Necessary for Life-Saving Progress to Continue

By Gwen Rathbun, Director, Federal Government Affairs at the American Diabetes Association.

The Special Diabetes Program (SDP) saves lives and provides an undeniable return on investment. Although the continuing resolution (CR) that the federal government is currently operating under extends SDP until November 21st, the program urgently needs a long-term renewal.

SDP is comprised of two important components: the Special Statutory Funding Program for Type 1 Diabetes Research (SDP-type 1) and the Special Diabetes Program for Indians (SDPI). Together, these programs represent a small federal investment with a large impact.

There is no cure for diabetes; more than 30 million Americans are living with diabetes and an additional 84 million are at heightened risk of developing it. And it’s expensive, with diagnosed diabetes costing our economy $327 billion each year. Medical expenses for those with diabetes are 2.3 times higher than for those without the disease.

American Indian/Alaska Native (AI/AN) communities experience a 15.1% overall prevalence of diabetes, and AI/AN individuals are twice as likely as white Americans to have diabetes. The disease has devastated entire communities, but the tide is turning. Administered by the Indian Health Service (his), SDPI provides 301 tribal grantees with funding for diabetes prevention and treatment. Although AI/ANs still have the highest rate of diabetes in the US, their rate of kidney failure decreased 54% between 1996 and 2013. This decline coincided with the implementation of SDPI and led to $436 to $520 million in savings to Medicare over a ten-year period.

Additionally, SDP-type 1 funding at the National Institutes of Health (NIH) has supported targeted, high-risk, high-reward research projects toward a cure and better therapies and yielded two incredible results earlier this year. An immunotherapy drug (teplizumab) was found to delay the diagnosis of type 1 diabetes by an average of two years in those at highest risk-- those who have a family member with diabetes and had autoantibodies present suggesting an increased risk for developing diabetes. Currently, having a family member with type 1 diabetes increases the risk of developing the disease 15-fold. Additionally, SDP-type 1 funding accelerated the development of the artificial pancreas, and a six-month study of an artificial pancreas system showed that it outperforms standard insulin pump and continuous glucose monitoring. The artificial pancreas system was found to improve blood glucose of the study participants living with type 1 diabetes, which is key in preventing devastating and costly complications.

Both components of SDP provide a clear return on investment and have tremendous bipartisan support. Earlier this year, 378 members of Congress and 68 Senators signed letters to leadership in support of SDP. Unfortunately, SDP was not renewed prior to the end of the 2019 fiscal year, but Congress wisely included a short-term extension of the program in the CR.

Congress’s work is not done: we call on Congress to renew SDP for 4 or 5 years (as the House Energy and Commerce Committee and Senate Health, Education, Labor, and Pensions Committee recommend earlier this year). A long extension makes it possible for the National Institutes of Health and Indian Health Service to fund the research and programs that have the greatest impact.

Diabetes is our country's most costly disease in both human and economic terms, affecting people of all ages and races and in every region of our country. We urge Congress to work on a bipartisan agreement to extend SDP for as long as possible.