Robert D. German

Washington, D.C., April 28, 1999—Today, Robert D. German, a member of the Juvenile Diabetes Foundation International Board of Directors, presented the following testimony before the House Appropriations Subcommittee on VA, HUD, and Independent Agencies regarding fiscal year 2000 appropriations for VA Medical Research and NASA Office of Life and Microgravity Science and Applications

Good afternoon. My name is Rob German, and I am an attorney with the law firm of Sherrard, German & Kelly in Pittsburgh, Pennsylvania. I appear before you on behalf of the Juvenile Diabetes Foundation International (JDF), where I serve as a member of its Board of Directors, to testify in support of fiscal year 2000 appropriations for the Department of Veterans Affairs (VA) medical research programs and the National Aeronautics and Space Administration’s (NASA) Office of Life and Microgravity Science and Applications.

    JDF’s mission is to find a cure for diabetes and its complications through the support of research. It is the world’s leading nongovernmental, nonprofit supporter of diabetes research. This fiscal year, JDF expects to support more than $55 million in diabetes research.

    Although JDF is a research funding organization, I am not a scientist. I appear before you today as a dad. I have been an active JDF volunteer since my son, Christopher, came down with the disease almost eleven years ago. I am happy to report that my son, who is almost seventeen years of age, is surviving his diabetes—but that is all that he is doing when it comes to his diabetes!

    Christopher pricks his finger to test his blood sugar five to six times a day and is injecting himself with insulin an average of four times a day. His daily food intake is extremely regimented as to type, amount and when it must be eaten. Christopher does this everyday of his life in an effort to keep his blood sugar levels within acceptable ranges in an effort to try to reduce the risk of future significant medical problems brought on by the disease. Those potential medical problems include blindness, kidney failure, heart disease, stroke, and amputations. Christopher never gets a day off from diabetes. You can imagine how difficult this lifestyle would be for anyone to maintain, especially an active teenager.

    Individuals with diabetes face many hurdles in dealing with their health beyond even the day-to-day difficulties of living with the illness. A perfect example is an upcoming wisdom tooth removal. Most people can have their wisdom teeth extracted as an outpatient and be home within several hours. Unfortunately, Chris must be hospitalized for two to three days so that his blood sugar levels can be properly maintained in the absence of certain food.

    Virtually every JDF parent has made the same promise to his or her child—to do everything possible to find a cure for diabetes and its complications. JDF is doing its share to support this effort, and we seek the enhanced help of the federal government—and your commitment as well—to help speed our path to a cure.

    JDF places a great deal of attention on the important diabetes research programs within the National Institutes of Health, where the bulk of federally supported diabetes research is carried out. Less well known is our support for the diabetes research programs within VA and NASA.

JDF/VA Partnerships
Diabetes is a great strain on the VA health-care system. The VA estimates that 15 percent of all veterans suffer from diabetes (compared to 3.1 percent of the general population and 8 percent of the Medicare population), and nearly 25 percent of all pharmacy outpatient costs are attributable to persons with diabetes.

    JDF established public–private research partnerships with the VA in 1996 to further advance our mutual interests in curing diabetes and its complications. So far, our partnership has resulted in diabetes research centers in Iowa City, Nashville, and San Diego, and we are working with the VA to identify additional projects that would be appropriate for joint funding.

    Within our centers, we are developing new strategies to help veterans—and all Americans—help battle the devastating complications of diabetes. In particular, current and future JDF/VA partnerships will focus on new treatments to help veterans who suffer from complications such as heart disease, blindness, kidney failure, and nerve damage.

    Mr. Chairman, we hope the Subcommittee will support the Friends of the VA Medical Care and Health Research coalition’s request for $360 million for VA Medical and Prosthetics research. This would provide a $44 million increase in funding over last year’s budget, and it would allow the VA to maintain existing projects and expand research into diabetes and other fields.

NASA Diabetes Research
JDF is working with NASA to advance our understanding of diabetes and to develop new treatments. NASA’s Office of Life and Microgravity Science and Applications undertakes research projects that are relevant to issues affecting the diagnosis and treatment of diabetes and its complications.

    Among the research areas of mutual interest to JDF and NASA are the following:

• Diabetic Retinopathy: Diabetes is the leading cause of new adult blindness. NASA is developing new techniques that will permit early diagnosis of diabetic retinopathy suitable for mass screening. In addition, JDF and NASA recently cosponsored a major national research conference on issues relating to diabetic retinopathy research.
• Noninvasive Blood Glucose Monitoring: NASA is searching for ways to allow its astronauts to avoid invasive procedures for testing their blood. My son, Christopher, tests his blood sugar multiple times each day. If we can develop non-invasive technologies, it will aid individuals with diabetes in day-to-day blood sugar control as well as assist astronauts in space.
• NASA Bioreactor Program: NASA maintains a bioreactor that is showing great promise in helping us understand more about the biology of insulin-producing beta cells. In addition, the bioreactor is helping us study ways that insulin-producing cells can replicate in microgravity environments, which we hope will provide us with an endless source of such cells for eventual transplantation in persons with diabetes.

    Mr. Chairman, we are requesting $300 million for NASA’s Office of Life and Microgravity Science and Applications program, an increase of $36 million over last year’s funding level.

Summary
Mr. Chairman, thank you once again for the opportunity to testify before you today. We believe that the work of the VA and NASA in diabetes research will help speed the path to a cure for diabetes, and we thank you for your strong support.