The National Clinical Care Commission Report to Congress: Background, Methods, and Foundational Recommendations

Herman, William H.; Bullock, Ann; Boltri, John M.; Conlin, Paul R.; Greenlee, M. Carol; Lopata, Aaron M.; Powell, Clydette; Tracer, Howard; Schillinger, Dean

doi:10.2337/dc22-0611

Cited by 5 publications

(16 citation statements)

References 63 publications

(74 reference statements)

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“…The NCCC’s guiding socioecological framework ( Fig. 1 ) ( 9 , 10 ), and the population-level recommendations that flowed from this framework, represent a major shift in how the federal government can address the diabetes epidemic. While adopting these recommendations could significantly reduce diabetes incidence, complications, and costs in the U.S., substantial political resolve will be needed to translate recommendations into policy.…”

Section: Discussionmentioning

confidence: 99%

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs for Population-Level Diabetes Prevention and Control: Recommendations From the National Clinical Care Commission

et al. 2023

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The etiology of type 2 diabetes is rooted in a myriad of factors and exposures at individual, community, and societal levels, many of which also affect the control of type 1 and type 2 diabetes. Not only do such factors impact risk and treatment at the time of diagnosis but they also can accumulate biologically from preconception, in utero, and across the life course. These factors include inadequate nutritional quality, poor access to physical activity resources, chronic stress (e.g., adverse childhood experiences, racism, and poverty), and exposures to environmental toxins. The National Clinical Care Commission (NCCC) concluded that the diabetes epidemic cannot be treated solely as a biomedical problem but must also be treated as a societal problem that requires an all-of-government approach. The NCCC determined that it is critical to design, leverage, and coordinate federal policies and programs to foster social and environmental conditions that facilitate the prevention and treatment of diabetes. This article reviews the rationale, scientific evidence base, and content of the NCCC’s population-wide recommendations that address food systems; consumption of water over sugar-sweetened beverages; food and beverage labeling; marketing and advertising; workplace, ambient, and built environments; and research. Recommendations relate to specific federal policies, programs, agencies, and departments, including the U.S. Department of Agriculture, the Food and Drug Administration, the Federal Trade Commission, the Department of Housing and Urban Development, the Environmental Protection Agency, and others. These population-level recommendations are transformative. By recommending health-in-all-policies and an equity-based approach to governance, the NCCC Report to Congress has the potential to contribute to meaningful change across the diabetes continuum and beyond. Adopting these recommendations could significantly reduce diabetes incidence, complications, costs, and inequities. Substantial political resolve will be needed to translate recommendations into policy. Engagement by diverse members of the diabetes stakeholder community will be critical to such efforts.

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Section: Discussionmentioning

confidence: 99%

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs for Population-Level Diabetes Prevention and Control: Recommendations From the National Clinical Care Commission

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“…The methods employed by the NCCC have been described previously (50). Briefly, the 23 members of the NCCC formed…”

Section: Methodsmentioning

confidence: 99%

“…The methods employed by the NCCC have been described previously ( 50 ). Briefly, the 23 members of the NCCC formed three subcommittees that gathered information from federal agencies, stakeholders, key informants, and the public as well as a systematic search and review of the scientific literature.…”

Section: Methodsmentioning

confidence: 99%

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs to Prevent Diabetes in People With Prediabetes

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Individuals with an elevated fasting glucose level, elevated glucose level after glucose challenge, or elevated hemoglobin A1c level below the diagnostic threshold for diabetes (collectively termed prediabetes) are at increased risk for type 2 diabetes. More than one-third of U.S. adults have prediabetes but fewer than one in five are aware of the diagnosis. Rigorous scientific research has demonstrated the efficacy of both intensive lifestyle interventions and metformin in delaying or preventing progression from prediabetes to type 2 diabetes. The National Clinical Care Commission (NCCC) was a federal advisory committee charged with evaluating and making recommendations to improve federal programs related to the prevention of diabetes and its complications. In this article, we describe the recommendations of an NCCC subcommittee that focused primarily on prevention of type 2 diabetes in people with prediabetes. These recommendations aim to improve current federal diabetes prevention activities by 1) increasing awareness of and diagnosis of prediabetes on a population basis; 2) increasing the availability of, referral to, and insurance coverage for the National Diabetes Prevention Program and the Medicare Diabetes Prevention Program; 3) facilitating Food and Drug Administration review and approval of metformin for diabetes prevention; and 4) supporting research to enhance the effectiveness of diabetes prevention. Cognizant of the burden of type 1 diabetes, the recommendations also highlight the importance of research to advance our understanding of the etiology of and opportunities for prevention of type 1 diabetes.

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“…Accordingly, diabetes in the U.S. cannot simply be addressed as a medical problem. It must also be addressed as a societal problem involving diverse sectors including food, housing, commerce, transportation, and the environment ( 1 , 4 ). The recommendations of the National Clinical Care Commission (NCCC) are rooted in the understanding that to improve the health outcomes of people at risk for and with diabetes, all of these sectors must be engaged.…”

Section: Introductionmentioning

confidence: 99%

“…The recommendations of the National Clinical Care Commission (NCCC) are rooted in the understanding that to improve the health outcomes of people at risk for and with diabetes, all of these sectors must be engaged. The recommendations of the NCCC are informed by both the Socioecological Model and the Chronic Care Model and are aligned with a “health-in-all-policies” approach ( 1 , 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

The National Clinical Care Commission Report to Congress: Summary and Next Steps

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The U.S. is experiencing an epidemic of type 2 diabetes. Socioeconomically disadvantaged and certain racial and ethnic groups experience a disproportionate burden from diabetes and are subject to disparities in treatment and outcomes. The National Clinical Care Commission (NCCC) was charged with making recommendations to leverage federal policies and programs to more effectively prevent and control diabetes and its complications. The NCCC determined that diabetes cannot be addressed simply as a medical problem but must also be addressed as a societal problem requiring social, clinical, and public health policy solutions. As a result, the NCCC’s recommendations address policies and programs of both non–health-related and health-related federal agencies. The NCCC report, submitted to the U.S. Congress on 6 January 2022, makes 39 specific recommendations, including three foundational recommendations that non–health-related and health-related federal agencies coordinate their activities to better address diabetes, that all federal agencies and departments ensure that health equity is a guiding principle for their policies and programs that impact diabetes, and that all Americans have access to comprehensive and affordable health care. Specific recommendations are also made to improve general population-wide policies and programs that impact diabetes risk and control, to increase awareness and prevention efforts among those at high risk for type 2 diabetes, and to remove barriers to access to effective treatments for diabetes and its complications. Finally, the NCCC recommends that an Office of National Diabetes Policy be established to coordinate the activities of health-related and non–health-related federal agencies to address diabetes prevention and treatment. The NCCC urges Congress and the Secretary of Health and Human Services to implement these recommendations to protect the health and well-being of the more than 130 million Americans at risk for and living with diabetes.

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The National Clinical Care Commission Report to Congress: Background, Methods, and Foundational Recommendations

Cited by 5 publications

References 63 publications

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs for Population-Level Diabetes Prevention and Control: Recommendations From the National Clinical Care Commission

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs for Population-Level Diabetes Prevention and Control: Recommendations From the National Clinical Care Commission

The National Clinical Care Commission Report to Congress: Leveraging Federal Policies and Programs to Prevent Diabetes in People With Prediabetes

The National Clinical Care Commission Report to Congress: Summary and Next Steps

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