resources : fact sheets : sdpi–demonstration projects : diabetes prevention and healthy heart demonstration projects

Fact Sheets

Special Diabetes Program for Indians: Demonstration Projects	print version (PDF - 266 KB)
Diabetes Prevention and Healthy Heart Demonstration Projects	updated June 2008

Halting the progression of the diabetes epidemic depends in large part on whether findings from diabetes research can be translated successfully in real world settings. In response to this challenge, Congress directed the Indian Health Service (IHS) to launch the Special Diabetes Program for Indians Demonstration Projects in 2004. These five-year projects focus on preventing diabetes in American Indians and Alaska Natives and reducing cardiovascular disease risk in American Indians and Alaska Natives who already have diabetes.

The IHS set aside $27.4 million (out of a total $150 million) of Special Diabetes Program for Indians funding per year from fiscal year 2004 through fiscal year 2008 for the Demonstration Projects. In 2004, the IHS awarded Demonstration Project grants to 66 IHS, Tribal, and Urban Indian health programs for one of two programs: (1) the Diabetes Prevention Demonstration Project, or (2) the Healthy Heart Demonstration Project.

Diabetes Prevention Demonstration Project: 36 grant programs

The Diabetes Prevention Demonstration Project focuses on preventing diabetes in American Indians and Alaska Natives at risk for developing the disease. This project adapted, and is currently implementing, the curriculum from the National Institutes of Health (NIH) Diabetes Prevention Program (DPP). This landmark study, published in 2002, demonstrated that individuals with pre-diabetes could prevent type 2 diabetes through lifestyle changes and, to a lesser extent, with a medication called metformin. The grant programs are implementing activities that translate the DPP findings and methods specifically for American Indian and Alaska Native communities, including: A 16-week diabetes prevention curriculum. Lifestyle coaching and behavior change activities. Healthy eating practices. Physical activity and weight management. The DPP demonstrated that the lifestyle intervention not only prevented diabetes, but also yielded cost savings, enhanced quality of life, and enhanced productivity. Consequently, this Demonstration Project could have a major impact on reducing the enormous costs of treating diabetes and its complications among American Indians and Alaska Natives.

Healthy Heart Demonstration Project: 30 grant programs

The Healthy Heart Demonstration Project focuses on reducing the risk of cardiovascular disease in American Indians and Alaska Natives who already have diabetes. Cardiovascular disease is the leading complication of diabetes, and the number one killer of American Indian and Alaska Native adults. The grant programs are currently implementing a clinical, team-based, case management approach to treat risk factors for cardiovascular disease. This approach is based on current models for chronic illness care and the latest cardiovascular disease prevention clinical guidelines and includes: Blood sugar and blood pressure control. Reducing cholesterol levels. Aspirin use and smoking cessation. Physical activity and weight management.

Early progress of the Demonstration Projects

The grant programs successfully began implementation of the rigorous Demonstration Project activities in fiscal year 2006. In addition, the grant programs have launched community awareness activities tailored to meet the local needs and priorities of individual American Indian and Alaska Native communities. Diabetes Prevention Demonstration Project By January 2007, the grant programs had recruited a total of 1,043 participants into the Diabetes Prevention Demonstration Project. Most of these individuals were newly diagnosed with pre-diabetes through the project. As a result, these individuals have the opportunity to participate in a successful diabetes prevention intervention. Healthy Heart Demonstration Project By January 2007, the grant programs had recruited a total of 961 participants into the Healthy Heart Demonstration Project. All of these individuals already had diabetes, but did not previously have access to the type of intensive case management and chronic care management offered by the project.

Spreading quality diabetes care throughout the Indian health system

The IHS Division of Diabetes Treatment and Prevention will dedicate the final year of this project (fiscal year 2008) to disseminating project results and lessons learned throughout the Indian health system. These results will help the Indian health system understand how to best translate the research on diabetes treatment and prevention in the real world settings of American Indian and Alaska Native communities and their health care systems.

The IHS Division of Diabetes Treatment and Prevention will share lessons learned from the Demonstration Projects with other Indian health programs to help them start new diabetes prevention and cardiovascular disease risk reduction activities.