Achieving normal glycemic control by implementing an American Indian approach diabetes prevention program for non-complicated type II diabetes

Indian Health Center of Santa Clara Valley (IHC) has implemented the Diabetes Prevention Program (DPP) since 2004. The curriculum is based on a study by the National Institute of Health which found that an intensive lifestyle intervention can lower the risk of diabetes by 58%. In 2004 the Indian Health Service funded DPP pilot programs to translate the NIH study from research to community settings. IHC's DPP is an innovative 17-week lifestyle change program taught by a multidisciplinary team of professionals including a Registered Dietitian, Certified Diabetes Educator, Mental Health Counselor, Kinesiologist, and Health Educators. Baseline/follow up labs and surveys are obtained to track outcomes. The IHC DPP annual diabetes conversion rate is 1% as compared to the NIH study predicted rate of 11% without the intervention. Due to DPP's tremendous success, in 2007 IHC pursued funding to expand to other populations. In 2010, IHC contracted with a Public Health Sector insurance plan to provide DPP to participants with pre-diabetes with a Fasting Blood Glucose (FBG) of 100-125 and patients with non-complicated Type II diabetes. Patients with a FBG >125 and no complications were referred by their primary care physicians. Of 32 participants, 18 were diagnosed with diabetes. Follow up labs indicate 44% of those with diabetes decreased their FBG from diabetic range to pre-diabetic range (<125), with 5% decreasing to normal glycemic range (<100). Using IHC American Indian DPP concepts, participants with non-complicated diabetes were able to lower their risk of diabetes complications and increase their quality of life.