In January, the National Clinical Care Commission (NCCC), a panel funded by the United States Department of Health and Human Services (HHS) completed its three-year mission and submitted a report updating recommendations on the care of diabetes-related complex metabolic and autoimmune diseases to the US Secretary of HHS and the US Congress. Ayotunde Dokun, MD, PhD, FACE, Associate Professor of Medicine, FOEDRC Verna Funke Chair in Diabetes Research and director of the Division of Endocrinology and Metabolism, was of one only thirteen nonfederal employees tapped to serve on the NCCC.
Almost 50 years have passed since the last time Congress requested a commission report, during which the landscape for diabetes diagnosis and treatment has dramatically changed. Diabetes has now reached epidemic proportions. In 2018, more than 1 in 7 US adults was diagnosed with diabetes and nearly half of those remaining were considered prediabetic. Beyond the serious health risks to these individuals, the potential impacts that diabetes presents for the health care system and the larger, long-term stability of US society are significant. The NCCC was therefore tasked with making recommendations on reduction both for the general population and those at higher risk of developing the disease, but also improving the health outcomes for those who have already been diagnosed through better management and treatment.
The resulting 192-page report does more than just talk about insulin, A1C targets, or peripheral neuropathy, but instead targets many of the social determinants of 
health in its recommendations. “One of our goals was to approach this as a societal problem,” Dokun said. “Prevention and management of diabetes touches every sector: housing, food, commerce, transportation, education. A multifactorial problem like this requires a multifactorial solution.” In fact, one of the overarching recommendations the report makes is that access to comprehensive, high-quality, and affordable health care must be available to everyone and all policies should be considered through the lens of reducing health care disparities.
The commission met as an entire group about three times each year, but smaller working groups communicated more often as they addressed their individual sections, Dokun said, who served on the treatment and complications working group. Now that it is in the hands of the Congress, Dokun hopes that they pay close attention to the entire report, using it as “a road map” to guide future policy decisions. “Each recommendation is very important to the future of diabetes care in the country.”