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	U.S. Department of Health and Human Services

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Thank you, Chris (Saudek), for your kind introduction. It's wonderful to be here with you today, and to receive the C. Everett Koop Award from the American Diabetes Association.

C. Everett Koop defined the role of the modern Surgeon General, and it's an exceptional honor to have an award with his name on it.

It's also an honor to be with some of the fine Americans I've come to know so well. As Secretary of Health and Human Services, you get to know a lot of people. And it's been a real pleasure to meet and work with the men and women of the ADA.

• Chris (Saudek), you've done great things as ADA President. Working with you was a true pleasure. Thank you for your selfless service.
• I understand that you're being succeeded by Dr Francine Kaufman, who traveled with me to Europe last month to attend a meeting of the World Health Organization. Fran, thank you for working with me, and I look forward to your presidency.
• I've also had the pleasure of meeting Michael Mawby, whose professionalism was evident from the moment we met.
• John Graham is also here - John, you're CEO, so you have to keep these bright minds in line. Good luck!
• And I'd like to recognize Miss Quinn Nystrom, who has succeeded the very dynamic young Cullinan Williams as your National Youth Advocate. Quinn, when I was 15, my ambition was to be prominent in Wisconsin. You're already prominent throughout America. Well done.

The ADA is a great organization that does so much to help millions of men, women and children throughout our country. We hear a lot these days about the life-savers in our country - the firemen, the soldiers, the policemen. And they deserve the attention.

But there are others among us who save lives in their own quiet way, by educating and informing about disease, about safety, and about prevention. My friends, you are some of those quiet heroes. I thank you for the great work you do for all of us.

I've been so impressed by your professionalism, your dedication, and your resolution. We share a common vision of an America free of the scourge of diabetes. And we work together to make it happen.

Make no mistake - it is a terrible scourge. The numbers we've gotten over the past several months are alarming. Right now, 17 million Americans are suffering from diabetes.

This is why my department worked with the ADA to define a medical classification called pre-diabetes, covering 16 million Americans whose blood glucose levels are higher than normal. These are people likely to become diabetic in the next ten years. I cannot emphasize enough just how crucial this pre-diabetes category is. By identifying people with this condition, we have the chance to change behaviors and save lives.

I want to thank you of the ADA here, in person, for your fine work on this. What you did with us on pre-diabetes was a great example of how we, working together, can make a difference in the lives of our fellow Americans. Thank you for your leadership, and thank you for your dedication.

Diabetes isn't just a disease in itself. With it come grave risks. The risk of blindness. The risk of kidney disease. The risk of renal failure. The risk of amputation.

I've been to the Pine Ridge Sioux reservation in South Dakota, to visit one of the populations most affected by diabetes. In these communities, I saw the terrible toll that diabetes takes. The lost limbs and crippled lives break the heart. Old and young must line up on Saturday mornings for dialysis, where they are tethered to a machine. That is unacceptable.

There's another critical risk that diabetes carries with it - the risk of cardiovascular disease. I know this danger firsthand. My own father suffered from diabetes - and he died young, of a heart attack at age 61.

It's a risk that Americans know shockingly little about. It was my privilege to join you and the American College of Cardiology when we released the startling news that more than two-thirds of people surveyed did not consider cardiovascular disease to be a serious complication of diabetes.

People with diabetes are more likely to die from a heart attack and are more likely to have multiple heart attacks or strokes than those without diabetes. In fact, it's been shown that diabetes actually puts a person at a two-to-four times higher risk of having a stroke.

With cardiovascular disease the number one killer of Americans, this ignorance is deadly. What people don't know will kill them.

And with 7 in 10 adults not regularly physically active, and 4 in 10 completely inactive - it does.

That's where prevention comes in. The overwhelming majority of diabetics suffer from type 2 diabetes. That is where our opportunity lies - type 2 is largely preventable, and the prevention is surprisingly easy.

I'm passionate about prevention, my friends. It is so vital to preventing diabetes and so many other health problems in America.

A modest and attainable improvement in our level of activity and the food we eat will work wonders. It is scientifically proven that moderate physical activity can substantially reduce the risk of developing type 2 diabetes - not to mention heart disease, colon cancer, high blood pressure and obesity.

Just focusing on three achievable things can substantially improve our health and prevent the onset of disease:

First, be active. Just 30 minutes of walking a day, five days a week, can reduce your risk of type 2 diabetes by nearly 60 percent.

Second, enjoy five fruits and vegetables a day. Science proves that fruits and vegetables can help prevent disease, including colon cancer and heart disease.

Third, don't smoke. If you do, quit. If you don't, don't start.

A few months ago, I had the privilege of meeting a fine American named Cedric (see-drik) Williams. Cedric has type 2 diabetes, and he decided to do something about it.

After suffering a stroke, Cedric adopted a new lifestyle with a healthier diet and regular exercise. Today, he walks 10 miles a day, has shed 150 pounds and no longer needs insulin shots. He shared his story with America in the January issue of People magazine.

We can all emulate the example of Cedric Williams. I've publicly set my own goal of losing 15 pounds, and I'm happy to say that I'm on my way.

We should all be particularly concerned about America's children. Type 2 Diabetes was once a disease of adults 40 and older. Now it's found in children as young as eight. And it's growing.

Why? It's because our children are more sedentary and overweight than ever before. In fact, the number of overweight children has tripled in the past two decades.

We need to get serious about our children's lifestyles and get them active for at least an hour every day.

We need to get our children off the Play Stations and onto the Playgrounds.

One of the most promising developments in years for the treatment of type 1 diabetes has been the slow perfection of the process of islet (eye-let) cell transplants. These cells, found in the human pancreas, can actually produce the insulin that a person needs.

But to get islet cells - and even to do islet cell research - you need a human pancreas.

We are acting to make sure that concern need not turn into worry for the parents and friends of children with juvenile diabetes. That's why I've launched a nationwide initiative to encourage organ donation.

I am passionate about this. Last year, we helped increase organ donations by almost 7 percent. That's progress, but it's only the beginning.

Almost 80,000 Americans are waiting for organ transplants. That's too many - and too many of them wait for a pancreas that could free them from a lifetime of diabetes.

As of last week, 294 Americans were waiting for islet cell transplants. And the number keeps getting larger. Yet the available donor pancreata would cover only a fraction of the people who could benefit. It's clear that new sources of islet cells are critical.

We have established a Beta Cell Consortium to pursue methods for growing an unlimited quantity of functional insulin-secreting islet beta cells.

As you know, one of the areas of research that shows great promise for the treatment of Type 1 diabetes is stem cell research. If researchers can coax stem cells into becoming insulin-producing islet cells, it would provide a virtually unlimited supply of such cells available for transplantation.

Type 1 diabetes may be something we have to live with for now. But it will never be something we have to simply accept as inevitable.

Our efforts at fighting it are bearing fruit. According to a type 1 diabetes registry, death rates fell from 8.4 percent in those diagnosed between 1965 and 1969 - to 3.5 percent in those diagnosed between 1975 and 1979. That's progress. And we're not letting up.

Let me tell you right now - we're doing everything we can to make diabetes a bad memory. Our National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is leading the way. We've asked for a $138 million increase in its budget so it can continue its fine work.

We have several major initiatives against type 2 diabetes.

The Diabetes Prevention Program (DPP), spearheaded by NIDDK, clarified the steps that people can take to prevent or delay diabetes onset. The National Diabetes Education Program - a joint effort of the NIDDK, the CDC, and over 200 private partners - is working to disseminate the DPP's prevention message to the public.

To determine the prevalence of diabetes in children and to help clarify trends in disease development, the CDC and the NIDDK are funding a study called SEARCH that will identify all cases of diabetes in children in six geographic areas of the United States.

NIDDK is also funding clinical trials to prevent and treat type 2 diabetes in children. These studies, currently being planned for recruitment next year, will try to develop ways to stem the rising rate of type 2 diabetes in children and to treat the disease safely and effectively in those who do develop it.

Two multicenter clinical trials spearheaded by National Heart Lung and Blood Institute and co-funded by NIDDK will determine how best to prevent and treat heart disease in patients with diabetes.

We're also funding a great deal of research aimed at clarifying how genetic and environmental factors propel the molecular events that lead to diabetes. For example, the NIDDK supports the International Type 2 Genetic Linkage Consortium to help investigators combine individual studies and pool resources to localize diabetes genes.

NIDDK already supports a number of Diabetes Research and Training Centers and has recently issued a research solicitation to promote diabetes prevention and control efforts.

Last but not least, President Bush's fiscal year 2003 budget proposal will include $20 million for a new Healthy Communities Innovation Initiative that will focus on educating Americans about diabetes, asthma, and obesity. The Centers for Disease Control will run a complementary $5 million effort.

Last Wednesday, the Food and Drug Administration cleared two glucose test meters to be used with handheld computers. These devices will allow people with diabetes to more easily track and manage their blood sugar levels through use of computer technology. It's a sensible and powerful tool, and we're putting it where it belongs - in the hands of the people who need it.

I'm honored by this award, and by your generous praise, but we cannot rest on our laurels while there's still so much to do.

But I have no intention of declaring victory until a victory is won. I will not accept such a thing as a "tolerable" incidence of diabetes. I will not stand for an "acceptable" number of Americans dead or maimed from this disease. I will not rest while we can still research more - educate more - and treat more Americans.

In the Declaration of Independence, our Founding Fathers pledged their lives, their fortune, and their sacred honor to this country. Each of us here today must extend that commitment of honor, fortune, and life to ending diabetes in this nation. With your leadership, I know we can do it.

Again, I am deeply honored by the C. Everett Koop Award. God bless you, and God bless our great nation.