California Area Model Diabetes Program

United Indian Health Services , I n c. Model Diabetes Program
Arcata, California

VACANT, Coordinator
Tsurai Health Center
1600 Weeot Way
Arcata, C A 95521
Phone: (707) 825-5070
FAX: (707) 825-5055

Program Description

The United Indian Health Service (U I H S) is a tribal program, incorporated in 1970, serving an active patient population of approximately 6,000-8,000. The U I H S has a comprehensive clinic and community outreach program, including medical, dental, pharmacy and vision services.

Data/Epidemiology

• Diabetes registry numbers 381 people
• Diabetes prevalence = 0.04 (please note this is not age adjusted)
• Registry consists of people with diagnosis of diabetes type 1, type 2, impaired glucose tolerance and gestational diabetes.
• Computerized registry/list of people with diabetes and at risk to assure follow-up and case management.

Clinical Accomplishments

• Implemented standards/documentation/flowsheets
• Implemented staged diabetes management
• Complications screening and treating associated conditions that can contribute to the morbidity and mortality of diabetes (especially cardiovascular and renal disease)
• Blood glucose screening for individuals at the clinic and in the community to identify those with diabetes and also those at risk for diabetes.

Primary Prevention

• Family fun days/walks
• Stick game tournaments: traditional local games targeting male youth for life-long health habits
• Gathering Clinics/Conference: gathering local foods, grasses; targets mainly women of all ages for physical activity and life-long habits
• Registration/referral for abnormal blood glucose screenings.

Secondary Prevention

• Staged Diabetes Management protocols and clinical guidelines
• Flowsheets to coordinate care and document special exams for example, foot, eye, etcetera
• Gestational diabetes comprehensive screening and treatment program through the post-partum period.
• Community screen and referrals
• Lifestyle changes for those identified at high risk for developing diabetes (impaired glucose tolerance)
• Contact groups
• Education.

Tertiary Prevention

• Foot care program
• Ophthalmology
• Flowsheets/standards

Unique Accomplishments

• Staged diabetes management: clinical care adn treatment guidelines to improve the consistency and quality of diabetes care
• Community screenings
• PhD student dissertation "Sweet Tears and Bitter Pills"
• Diabetes Expansion Grant: works with other clinics in our service area to help develop their own unique diabetes program.

Resource Development

• "Owners Manual" (patient handbook regarding all aspects of diabetes)
• Blood glucose information sheets
• Dissertation on diabetes: Sociocultural view of Yurok Tribe.

Challenges

• Few Indian providers
• Rural/Large geographic area
• Associated health issues increase risk for the population