Kelly R. Moore, MD¹, S. Lorraine Valdez, BSN-RN, MPA, CDE¹, Tammy Brown, MPH, RD, BC-ADM¹, Cheryl A. Wilson¹, Susan Gilliland, PhD, RN², Yvette Roubideaux, MD MPH³, and Kelly J. Acton, MD, MPH². (1) Indian Health Service National Diabetes Program, 5300 Homestead Road NE, Albuquerque, NM 87110, 505-248-4182, kelly.moore@mail.ihs.gov, (2) National Headquarters Diabetes Program, Indian Health Service, 5300 Homestead Rd NE, Albuquerque, NM 87110, (3) Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, 500 N. Tucson Blvd, #110, Tucson, AZ 85716

Background: The Special Diabetes Program for Indians (SDPI) is a Congressionally-mandated intervention to fund diabetes prevention and treatment activities in AI/AN communities. In response to Congressional direction, the IHS implemented a consensus-based, Indian health best practices approach. 14 best practice models for successful diabetes prevention, treatment, and education practices in AI/AN communities were developed and SDPI programs were encouraged to use them. Methods: The IHS National Diabetes Program determined the percent of grant programs reporting access to clinical examinations, laboratory testing, medically effective diabetes therapies, and Medical Nutrition Therapy before and after SDPI. Sources of data included the Annual Diabetes Care and Outcomes Audit and questionnaires completed by the SDPI diabetes programs. Interventions were corroborated with key-informant interviews and expert observation from Area Diabetes Consultants. Results: Reported availability of clinical examinations of the eyes, feet and teeth and access to laboratory testing for assessing diabetes control and co-morbidities increased significantly with implementation of SDPI and a best practices approach. Access to newer diabetes medications, newer lipid lowering medications, ACE inhibitors and availability of Medical Nutrition Therapy services also increased. Conclusion: SDPI programs successfully used the best practice models to identify strengths and gaps in diabetes services and resources, establish program priorities, and develop work plans to implement local best practice models. Implementation of the SDPI grant program with “best practice” approaches to diabetes resulted in significant enhancements in diabetes care.

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