Achieving normal glycemic control by implementing an American Indian approach diabetes prevention program for seniors with 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. DPP's annual diabetes conversion rate is 1% as compared to the NIH study predicted rate of 11% without the intervention. 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. 30% of participants were seniors age 62 + and 50% of those were diagnosed with diabetes. At follow-up, lab results indicated that 42% of all seniors saw a drop in their glycemic index and 67% of diabetic seniors dropped below diabetic range. Using IHC American Indian DPP concepts, seniors with non-complicated diabetes were able to lower their risk of diabetes complications and increase their quality of life.