Things out and find your way. Many of those for you here i must focus my attention on things by doctor my health. Each day i had to carefully monitor and manage my blood glucose level, which isnt easy since exercise, diet and many other factors have an impact. Despite the serious challenges i have many reasons to be grateful. Fatefully, i was diagnosed with a t1 d after frederick branning discovered insulin. Thankfully, i was diagnosed with the wendy after insulin pumps and continuous glucose monitors were invented. Thankfully, i have learned how to manage my diabetes without allowing it to manage me even though it is not always easy. It is only through a very strict blood Sugar Management routine and advancements in diabetes treatment and devices that i have been able to live my life to the fullest. Thirtyfive, the number of countries i visited and is still counting. 13. 1, the number of miles and a half marathon. I have completed two so far. Ten, the number of things i wish my parents knew when i was diagnosed with t1 d. I wrote this article is a published author. For plus, the number of years after college that it takes to become a doctor like my dad who i look up to. That is my dream job. One, as in type one, the number associated with my disease. I am hopeful that congresses support we will move from type one to type none. Through it bases in medicine, my life has gotten easier healthier and safer. Are using insulin pump in a continuous glucose monitor. I am well aware that these advancements to much time, research and funding to become a reality. While i have never participated in a formal clinical trial, i am very excited about a recent Research Product that i conducted. Ive always been curious as to how and why my blood sugar is so irregular when i ski. Changes in now to two and prolonged activity can be very hard on blood sugar control. After researching i realized there was an opportunity to design a study to evaluate the changes my body experiences when i ski compared to my friends without diabetes. The results, which showed that sorry. The results, which represented at the summers American DiabetesAssociation Meeting in boston showed that despite strenuous activity, altitude cause an increased demand for insulin by more than a third. Most importantly, i show that my blood sugar could be in the same range as my friends with careful monitoring and planning of my, hydrates. The use of a continuous glucose monitor was especially helpful in preventing heiko glide hypoglycemia, and producing safe blood sugars prior to scheme. My project obviously does not compare to those responsible for the significant process made for the lifechanging treatment for t1 d. Projects with artificial pancreatic pancreas technology, Technology Hotel available in the years to come, but my project rivers of western desire to make an impact. I am not someone who can just stand by when there is so much to be done to improve my quality of life and that of my friends before you today. In closing, i ask for your support and testify to cure diabetes. Thank you chairman call it, Ranking Member mccaskill and Ranking Members of the committee today. [applause]. [applause]. Madam chairman, before we go on to the next witness may i ask unanimous consent that the record of this herein reflect something that the people behind million might not have seen, which is to record testimony she virtually never looked down at her notes, which is far better than most adults. I just hope she doesnt run against me. [laughter] i would be in trouble if that happens. That really was extraordinary testimony and we thank you so much for being here today. Now, we will turn to another extraordinary young woman, kate hall. s directed afternoon. My name is kate hall and i am from maine. Thank you chairman call it, Ranking Member mccaskill and members of the committee for the honor of being here today to share my experience of living with type one diabetes. I was diagnosed with type one diabetes when i was 10 years old. At first it seemed as if i would never understand every little detail that was involved in having diabetes. I had to adjust to taking shots of insulin, checking my blood sugar several times a day, learning how to count carbs in everything i ate and learning how to deal with high and low blood sugar. However, the thing that stood out to me the most was being benched in my first soccer game after my diagnosis. That made me realize that diabetes wasnt going to ever stop me from doing the things i love most. I thought, i am not sitting out on anything ever again if i can help it. Im figuring this thing out. Type one diabetes is challenging to put it comes to what love doing most, track and field for the events i competing, the long jump in the short sprint require rigorous training. For me because i live with type one diabetes keep me because i e one diabetes keep in my blood sugar in a healthy range as much as possible is as just an important part of my training as anything else i do to prepare for competition. Managing my diabetes can be hard at times and i realize i cant figure everything out on my own. I need help from doctors, my parents, Diabetes Technology and researchers. Being a competitive track and field athlete there are many tiny details involved that people have to do to get the best result possible. Some of these include staying hydrated, eating well, sleeping well, training the right way and warming up correctly to prevent injury. But only do i have to do all of these things, but making sure my blood sugar is at a another thing to add to the list. Whenever i am training or competing i had to take my blood sugar several times before i read to make sure it wont go higher low even when i try my hardest to control it. I where an insulin pump. With most private Health Insurance covering cgm i am hopeful i can update my policy. This helps me focus on training and competing. Thankfully knew technology and the support of my family will allow me to pursue my passion and become a world ranked junior athlete. I was able to end my career by breaking a 39 yearold National Record at the new balance nationals last month my jump surpassed the automatic qualifying standard for the 2016 olympic trials. I finished 3rd in the 100meter event. My dream is to one day represent the United States at the olympics. Although i will be far from home one key part of my life remains unchanged the challenges of managing my type one diabetes everyday. Technology is important but we need a scientist to help us figure out better treatments and the cure for this disease which is why my family and i are grateful for the funding. Chairman, we thank you for your leadership and are counting on congress to help us figure it out. Thank you. Thank you. [applause] i just want to say personally how proud i am of you. It was thrilling to hear of your success and setting new records, and to do so while coping with a very complicated illness is even more impressive. Most impressive. Most of all, you inspire all of the children who are here today to no that they, too, can achieve there dream. So thank you for coming. Welcome. Chairman collins, Ranking Member mccaskill, members of the committee, thank you for this opportunity to speak before you. You. My name is bob amato, and i am from Johnston Rhode island. When i was 1st diagnosed with type one diabetes i was 67 years ago, approximately seven years old. Thinking at that time, people such as you guys were not able to compete. No athletics, no jim. That was difficult. I did not accept that, and i sought guidance from joslin and again guidance from my parents and i was able to prove that particular concept a fallacy, a fallacy to the point where in 2009 i was entered into the Providence College hall of fame for athletics for both my running accomplishments and accomplishments as a coach. As a coach i had the privilege of coaching to world champions, 16 division i allamericans. Teams competed and 116 new england championships. My coaching colleagues selected me to coach of the year 15 different times. That was what i would hope hope for when i was told it could not be done. I was able to find success despite the daily challenges of diabetes. Because i always used to five this is important, the term, the latest technology. The latest technology. You have the picture of that. When i 1st came down with diabetes the needles, are you ready for this one . The needles were metal. We had to sharpen the milestone. The syringes were glass. Blood 25 urine analysis, testing urine was the method of determining blood glucose. Now we are up to the insulin pump, and the technology is just fantastic about 15 years ago i began to realize that the normal low blood sugar warnings were no longer happening. All of you know that when you have aa low blood sugar you are either a little tired, shaky, or things happen that are not normal. But at this point in my diabetes career after 67 years those body signals are gone. And that provides me with some pretty big dangers. I neededdangers. I needed to find a way to manage that situation. I was fortunate that the gdr s funded Research Program using the continuous glucose monitor, the cgm which took place in boston, and i was one of the 1st to start in on that. We spent about a year with the program. It was great. I went from not realizing what was going on with regards to insulin reactions as we used to call them, low blood sugars, hypoglycemia. You guys are all familiar, to no knowing ahead of time what to do and how to correct it. It also enables me to control my diabetes better which again is very important. A new Technology Helps me with a situation that was really dangerous. As a result of the study and other studies the cgms were endorsed by leading clinics throughout the country, the inductor and society, American Diabetes association, american clinical american clinical 25 American Association of clinical endocrinologist. I dont knowi dont know what they are, great organizations, but we cannot relate to the. Almost every insurance agency, almost everyone is now on board. But there is still a tragedy, and that tragedy is medicare will not cover these things. I appealed to medicare over for solid years. The folder that i have is thicker than this. However, i received a notice that last november it was okay. The judge found in my favor. Well, i have the pleasure of coaching to world champions. The feeling i had was exactly the same when they told me we find in favor of you, but that was not all of the difficulty. Two months later they took it back and said no, and i, and i was heartbroken, but i have not given up. I have not given up. And that is what i hope you will do as you are going through school, high school later on in college and so forth. Do not quit. Now that i depend upon medicare for my diabetes, the cgms could save my life when i was wearing them numerous times. Again, i will not accept the cms decision, those are the administrators of the medicare program. The cgm can mean literally the difference between life and death. I will explain one instance. You have got to remember, we are trying to show that technology has helped me for 67 years be healthy and strong and successful. Now they have taken that technology away. I was driving on the interstate between boston and rhode island when not knowing, a reaction low blood sugar occurred. My car started to move back and forth on the highway. I did not realize that. An 18 wheeler didnt realize it, truck, truck, saw was happening, and he took and pushed my car off the road into the median. When the technicians took my blood sugar it was extremely low. That gentleman save my life. That did not have to happen. That did not have to happen. I could have been the cgm , if i had had that i would have known ahead of time, and things would have been taking care of. I couldi could have taken care of it. About a month ago i had a chance. Things have been difficult. I went up there alone. I hate to cut you off because your story is absolutely fascinating. I am worried because of the vote scheduling. If i could ask you to wrap up, that we will be great. Chairman, i would like to thank you for the opportunity of just being here and pleading for this particular situation and i hope that the vote that we will be taken from those that have been on assignment with you will continue. Continue. If anyone has any questions and i know you dont have the time, but if you have questions please be free to contact me and i would be glad to talk with you. Thank you for your compelling testimony. It is great to have you back chairman, senator, members of the committee, thank you for the invitation to testify today. A lifelonga lifelong disease that affects americans of all ages including seniors. On behalf of the National Institute of health pleased to report our Research Investment continues to improve the lives of type i diabetes. Through coordinated efforts with our Research Partners at j drf and 88 as well as a supporterthe support of the recently renewed special Statutory Funding Program for type one diabetes, we are helping children sitting here today and all people with type one diabetes live healthier lives and longer lives and im pleased to report that since i testified before you this Committee Just two years ago we have made significant scientific advances that are putting is closer to reaching our ultimate goal of preventing, treating, and ultimately curing type one diabetes and its complications. With the renewal of the program that you alluded to, we are looking forward to taking advantage of the future opportunities i would like to briefly describe for you today. Before i highlight these advances, i wanti want to acknowledge the important contribution my fellow witnesses of made and thank you for your personal testimony that you are not letting type one diabetes define you as a person. Ii am pleased to share the table with the doctors who we will share their Research Goals of preventing, treating command ultimately curing type one diabetes and would like to thank those here today representing americans of all ages with type one diabetes. Im happy to report the outlook is better than ever. People with the disease have knew and emerging technologies and treatments. And because of Research Conducted in the followup studies we know that early and intensive blood sugar control is key to reducing the risk of the devastating complications of the disease. Just this year we learned that people with diabetes who control their blood sugar levels are more likely to live longer than those are not an further emphasize the importance of early and intensive blood sure controls. As everyone here today knows controlling blood sugar is easier said than done. Challenging and burdensome and is limited by the potential for acute episodes of hypoglycemia promising approaches the artificial pancreas which is a device that can since blood sugar levels and automatically administer insulin. What this special Program Support theyre has been tremendous progress in this area. Just last year, 170 for five days and five nights by adults and adolescents led to lower blood sugar levels and reduced episodes of hypoglycemia. The study found an adolescent unsupervised overnight use of artificial pancreas for 21 nights led to improved blood sugar control during the day and night and reduce the number of episodes of nighttime hypoglycemia. Because of tremendous progress great promise in the nearterm approaching to help manage type one diabetes while improving health. However, it is not a cure. Replacing or restoring the function of the beta cells would be the biological cure in another area under vigorous investigation one strategy is via islet transplantation, collaborative islet transplant. Both safety and efficacy outcomes have improved from the year 2007 to 2010 compared to 1999 to 2006. Additional Research Progress areas have been made by an idd k and the niaid co led transplant consortium who has completed the pivotal trial and reached another endpoint in the 2nd phase three trial, and we look forward to these exciting results toward licensing pancreatic product for transplantation. A current barrier for using islet transplantation as a scarcity of donor islets for transplantation and here again and other major advance to overcome this difficulty has been recently reported by researchers in the Beta Cell Biology Consortium who have achieved the longstanding goal of type i Diabetes Researchone Diabetes Research discovering a way to create large numbers of glucose responsive insulin producing beta cells. With further research such cells could be used for transplantation to restore insulin producing capacity in patients with type one diabetes. Nih has made important strides in research to combat diabetes complications. Three drugs with widely differing costs. The results showed in people with mild vision loss all three drugs were equally effective. This canthis can inform clinical decisions and lead to more personalized treatment for diabetic eye disease while having significant cost implications and importantly drugs were found to improve vision which could make a difference in the quality of life that people with diabetes share. The in idd k and cdc have developed a study, and this program has shown that type one diabetes in people under the age of 20 has risen by 21 percent, the incidents has risen by 21 percent during the years 2001 to 2009 suggesting there is an environmental factor or factors contributing to disease risk, and our study of the environmental determinants which is now following 6,000 children from birth until the age of 15 we hope will soon get a handle on what is a murmur these environmentalists factors are. I know that the time is limited to select me in their. Chairman, members of the committee, thank you for the opportunity to testify before you today. The nih isthe nih is grateful for your continued support of congress, public and private partners, and the unwavering efforts of the