Bemidji Area Model Diabetes Program

Northern Minnesota Diabetes Resource Center
Cass Lake, Minnesota

Linda A. Fellows, MS, RD, LD,CDE
Interim Director, DiabetesCenter
Cass Lake Indian Hospital
425 - 7th Street N W
Cass Lake, Minnesota 56633
Phone: (218) 335-3244
FAX: (218) 335-3300
E-mail: linda.fellows@ihs.gov


Program Description

Established in 1988 with three Bemidji Area Service Units participting to (1) develop high quality diabetes programs for their particular communities and (2) to develop prevention and mangagement strategies and disseminate information throughout the area. In 1989 the Cass Lake Service Unit was selected to be responsible for the Area diabetes goals

Program Goals

• Implement a comprehensive high quality health care program which would promote active participation self-management
• Promote primary prevention through education and early detection through screening
• Provide assistance and share strategies with the regional and national Indian health network
• Provide continuous quality improvement of diabetes services and appropriteness of care.

Data & Epidemiology

• Leech Lake Reservation population is 6,260. There are 1,001 persons on the Diabetes Register, 726 people with diabetes actively seek care at Cass Lake Hospital. 34 Tribes in the Bemidji Area.

Clinical

• Implemented Diabetes Standards of Care
• Instituted Staged Diabetes Management (S D M) at Cass Lake
• Developed registries for Diabetes (D M), Gestational Diabetes (G D M), and offspring G D M pregnancy and ulcer/amputation
• Monitored quality of care through annual audits
• Provided continuous monitoring of new D M medications
• Developed and shared an appointment system to assure equality of diabetes clinic appointments.

Primary Prevention

• Screening for adults & high-risk children
• Education at worksites, health fairs & community events for diabetes prevention.

Secondary Prevention

• Clinic prescreening protocols developed, & flagging system desgigned to meet Standards of Care for all persons whether or not they attend diabetes clinic.
• Prenatal care incentive programs for positive health behaviors.
• Comprehensive clinic for annual eye, foot and dental care.
• Self blood glucose monitoring program-all persons eligible for monitors.
• Resource library for patients nd providers.

Tertiary Prevention

• Referrals for orthotics & laser treatments
• Talking blood glucose monitors for visually impaired.

Community

• Sponsorship of "Strong in Body & Spirit" program, "Support Group" training (Area wide)
• Developed interactive displays for nutrition & fitness education at health fairs and community events
• Nutrition, fitness & diabetes education for elders, Head Start, day care, women's services & chemical dependency programs--staff and participants.

Education

• Conferences & inservices: professional/para-professionals on diabetes
• Individual patients & family education
• Preceptorship at Diabetes Center for physicians, nurses, dieticians, etc.
• College classes for C H R s & other health workers

Resource & Product Development

• Holiday recipe book
• Fitness Program Challenges
• Comprehensive Foot Care-developing a program booklet & screening form
• Manual on corn, callus care and nail care
• Interactive education displays
• Review & field testing of I H S, National Institute of Diabetes & Digestive & Kidney disease materials
• Collaboration on publishing--12+ articles. Presentations at National I H S, A A D E, and Indigenous Peoples Conference

Challenges

• Understaffed for number of clients served & flat line budget for 5-6 years.
• Facility built in 1930's with some renovations
• Lack of space, extremely challenging for entire hospital

Unique Contribution

• National recognition foot care. The Program has excelled in sharing developments with other Indian programs, other agencies, Universities, etcetra.