During a Senate Appropriations Committee hearing on Wednesday, Sen. Lisa Murkowski (R-AK) asked National Institute of Diabetes and Digestive and Kidney Diseases Director Griffin Rodgers about the causes of diabetes and possible treatments for the disease.
00:00Senator Murkowski. Thank you. Thank you, Senator Collins, and thank you, Senator Cheney, for your leadership on this very important issue. And to the delegates that are here at the Children's Caucus, thank you.
00:13Thank you for not only being here, but your advocacy on behalf of so many. And to the witnesses that have shared your stories with us here in the Senate, know how important it is to have your voices, your fears, and your determination shared here.
00:37It encourages us. It motivates us to do more for you and with you. So thank you. Thank you for that.
00:48Dr. Rogers, I wanted to ask you, you just mentioned the environmental contributors to type 1 diabetes. We know that American Indians, Alaska Natives are more likely to be diagnosed with diabetes one and a half times more.
01:11Senator Collins has mentioned the special diabetes programs for Indians. It's really quite remarkable, the gains that we have seen with that focus.
01:24And it's so hard because when you come from an area where in your tribal communities the prevalence of diabetes may exceed 50 percent, I mean, that is really alarming.
01:39And these disparities have existed and persisted for generations.
01:44But what we've been able to see with the special diabetes program is really helping to reverse these trends.
01:53It's not only helped reduce diabetes-related complications, but led to a remarkable 54 percent reduction in new diabetes diagnoses among American Indian and Alaska Native youth, which is extraordinary.
02:07It's also contributed to a 50 percent reduction in new diabetes.
02:12It's also contributed to a 50 percent reduction in end-stage renal disease among Native people with diabetes.
02:14So can you, you mentioned the TEDDY study and the fact that it's almost completed after 15 years. That's significant.
02:24Are there other strategies or other efforts that are underway to include diversity of races and ethnicities where we know that there's greater prevalence of diabetes?
02:43Sure.
02:43Thanks for that question, Senator.
02:44And you're absolutely right. The special diabetes program aimed at American Indians, or SDPI, has been a sort of a program that is run in conjunction and in parallel with this SDP program.
03:01There, the aim is the implementation of the provision of care for individuals with diabetes.
03:08Now, what we've learned, and in large part due to the SDP, in conjunction with the Centers for Disease Control, NIDDK has a program called the SEARCH program, in which we are looking for diabetes in youth and adolescents, including type 1 diabetes.
03:28But something very remarkable, you mentioned the high prevalence of diabetes among American Indians and Alaska Natives.
03:37But there's been an increasing incidence of type 2 diabetes in youth and adolescents that has been uncovered by that SDP-supported search study.
03:49And I have to say that type 2 diabetes is even more aggressive, I have to say, than type 1 diabetes in youth.
03:59The therapies that we have for adults with type 2 don't work particularly well in youth and adolescents with type 2 diabetes.
04:09And the aggressiveness of the disease in terms of the time of diagnosis to the time of complication is much more accelerated.
04:18And so these, what we're learning now from the SDP program, we think we can potentially apply to type 2 diabetes in youth as well.
04:30One final thing I'll say, I don't want to dominate all of your time, but we really are very pleased with the success and the implementation of these artificial pancreas technologies.
04:42But there are certain areas that industry is a little bit reluctant to do trials to determine the success of that.
04:52And that's where we come in with SDP support.
04:54So, for example, women who are pregnant, there haven't been that many studies to determine the efficacy of artificial pancreas technology.
05:04Individuals who come from low income or low educational attainment, this is somewhere that we're stepping in.
05:13And it turns out that in the preliminary study, just minor modifications to this technology allows it to be utilized for a greater percentage of the population,
05:25including individuals, Alaska Natives and American Indians.
05:29So that's just one example or two examples of where we're moving in this area.
05:34Promising we need to do more.
05:36There's too many that are counting on all of us to again find this cure.
