The mission of the Indian Health Service (IHS) National Diabetes Program (NDP) is to develop, document, and sustain a public health effort to prevent and control diabetes in American Indian and Alaska Native peoples.

In 1979 Congress established the IHS National Diabetes Program in response to the epidemic of type 2 diabetes occurring in Indian communities.

The IHS National Diabetes Program

 
The National Diabetes Program provides
• Comprehensive diabetes surveillance (including total and age-specific prevalence rates of diabetes and diabetic complications across Indian country) at the local, regional and national levels
• Research translation
• Promotion of quality assurance / improvement activities in clinical and community programs through updated Standards of Care for Diabetes, the annual Diabetes Care & Outcomes Audit, and the Integrated Diabetes Care and Education Recognition Program
• Technical support to I/T/U sites nationwide through bulletins, updates and website information
• Resource information on a full complement of training opportunities including specialized training related to primary outpatient treatment models of diabetes management,
• Health care provider/ consumer education resources and "best practices" information to IHS, tribal and urban health programs
• Development, field testing and distribution of Native American-specific diabetes education printed and audio-visual materials to IHS & tribal health centers. In FY 2001, over 6500 diabetes education materials were sent to over 300 I/T/U programs nationwide

In addition, the NDP serves as the key IHS contact and source of information for outside organizations and agencies working on issues of diabetes and disparities related to diabetes and its complications.

As part of its ongoing programmatic activities, the IHS National Diabetes Program collaborates with the Centers for Disease Control, the National Institutes of Health, the American Diabetes Association, the American Association of Diabetes Educators, the National Diabetes Education Program, the National Indian Council on Aging, many state Department of Health Diabetes Control Programs, tribal colleges and universities, USDA, the National Diabetes Prevention Center, the Native American Diabetes Program (UNM), the American Podiatric Association, and the American Dietetic Association.

The IHS National Diabetes Program has a long and distinguished history of serving as a benchmark of diabetes clinical and public health excellence.

Late 70s:

Beginning in the late 1970s, the IHS Diabetes Program was a pioneer in developing a public health approach to diabetes in AI/AN communities.

Early 80's:

The NDP began to publish some of the first national epidemiologic surveillance data regarding the problem of diabetes in AI/AN. NDP staff tailored American Diabetes Association education program criteria to fit the unique needs of Indian communities and disseminated the adapted criteria nationally.

1986:

NDP developed the IHS Standards of Diabetes Care in 1986, prior to those published by the American Diabetes Association in 1988. The IHS standards are updated every 2 years based on the latest diabetes science. The IHS has been a leader in developing a diabetes care surveillance system, the annual Diabetes Care and Outcomes Audit, carried out voluntarily in Indian health facilities, to track performance on more than 87 indicators to study trends over time.

The Diabetes Care and Outcomes Audit monitors use of standards and outcomes of diabetes care, including blood sugar and blood pressure control, screening for complications, and preventive health services such as immunizations and smoking history. In the 2001 IHS Diabetes Care and Outcomes Audit, 15,146 charts were reviewed representing care to over 90,000 patients at 212 IHS and tribal health facilities in the 12 IHS Areas.

80s & 90's:

NDP began to publish articles in peer reviewed journals about its experience with using the Diabetes Care and Outcomes Audit to measure improvements in diabetes care for Indian communities. A 1994 GAO report outlining diabetes care to elderly Americans was compared to 1995 data from IHS. IHS performed significantly better on all five measures of quality care.

1990's:

NDP diabetes care surveillance system becomes instrumental in the improvement of diabetes care practices in many Indian health settings. For example, in a special program in Alaska and in northern Minnesota from 1989-93, lower extremity amputation rates were reduced by 50 percent in people with diabetes who received complete foot screening and protective footwear. This same system enabled IHS to measure improvements in blood pressure control in Montana after an intensive intervention in 1993.

The NDP develops a Renal Preservation Report as part of the Diabetes Care and Outcomes Audit to help providers and facilities identify their high-risk patient profile for impending kidney failure and to assess their progress on population-based prevention strategies for preserving kidney function.

1998:

Diabetes Program recognized by the Diabetes Quality Improvement Coordinating Committee as one of only two federal agencies who had collected quality improvement data available for comparison when the Diabetes Quality Improvement Project (DQIP) guidelines were announced. NDP becomes the largest grant program in the IHS

1999:

NDP invited to the World Congress on Diabetes Prevention conference to present a description of the Special Diabetes Program for Indians grant program. IHS Diabetes Program cited internationally as a model of community involvement and program effectiveness.

2000:

NDP invited to give a presentation at the American Diabetes Association Scientific Sessions on its 21 years of experience with measuring and improving diabetes care.

The NDP develops a Cardiovascular Disease Risk Profile Report as part of the Diabetes Care and Outcomes Audit to help providers and facilities identify their high-risk patient profile for development of cardiovascular disease and to assess their progress on population-based prevention strategies for preserving normal cardiac function.

2002:

NDP receives approval from CMS as a National Accreditation Organization for accreditation of AI/AN diabetes education programs to furnish and bill for outpatient diabetes self-management training. American Diabetes Association is the only organization with this authority.