Successfully Reducing Diabetes. Disparities among Urban Indians Aim: To prevent and treat diabetes in AI/AN populations (rural and urban) …
Diabetes Programs in Urban Areas: Successes, Challenges and Excellence in Data Collection and Service Delivery
Maile Taualii, MPH Rodney Stapp, MD Susan Mathew, RN, CDE, MS, BC-CNS, BC-ADM
Session: C1
Successfully Reducing Diabetes Disparities among Urban Indians
Presented by Dr Rodney Stapp on Behalf of Maile Taualii, MPH Urban Indian Health Institute, Seattle Indian Health Board
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The Urban American Indian and Alaska Native Population
Approximately 41 million individuals identified as American Indian or Alaska Native AI/AN alone or in combination with another race
15 of the total US population
Of 41 million, 67 live in urban areas Source: US Census, 2000
Urban Indian Health Organizations
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Diabetes: Major Health Issue for American Indians and Alaska Natives
Est 15 of adults served by Indian Health Service IHS have type 2 diabetes1 Prevalence rate 22 times that of non-Hispanic whites1 Death rate four times that of general population2 Affects AI/AN youth at higher rate than other races
174 vs 042 per 10003
1 CDC, 2 IHS,
National Diabetes Fact Sheet, 2005 Trends in Indian Health, 2000-2001 3 SEARCH for Diabetes in Youth Study Group, 2006
Special Diabetes Program for
Indians
Created in 1997 by IHS and other government agencies Aim: To prevent and treat diabetes in AI/AN populations rural and urban All urban Indian health organizations UIHO participate Contributed to significant increases in the availability of diabetes prevention, treatment and care
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Demonstrated Benefits of SDPI
Source: Wilson, et al 2005
Diab 
etes Audit of UIHO
Annual audit of UIHO diabetes registry charts Random sample Population: Adults; At least one primary care visit in last 12 months; Diagnosed with type 2 diabetes Years 2000 - 2005
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Diabetes Audit of UIHO: Results
Diabetes Audit of UIHO: Results
For combined years 2000-2005
61 Female 64 Obese BMI30 76 Monitored blood glucose
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Diabetes Audit of UIHO: Results
Duration of Diabetes: 2000-2005
45 40 35 30 25 20 15 10 5 0 423
243
246
89
5 Years
5-9 Years
10 Years
Missing
Diabetes Audit of UIHO: Results
Age: 2000 - 2005
60 50 40 30 20 10 03 0 15-44 45-65 65 Missing 259 177 561
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Diabetes Audit of UIHO: Results
Percent of Patients with HbA1c 65
35 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 214 236 251 272 270 326
Diabetes Audit of UIHO: Results
Percent of Patients with HbA1c 110
16 14 12 10 8 6 4
2 0 2000 2001 2002 2003 2004 2005 106 98 78 71 56 134
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Diabetes Audit of UIHO: Results
Percent of Patients with Blood Pressure 140/90 mm Hg
35 30 25 20 15 10 5 0 2000 2001 2002 2003 2004 2005 324 254 235 200 229 168
Diabetes Audit of UIHO: Results
Percent of Patients with Total Cholesterol 200 mg/dl
70 60 50 40 30 20 10 0 2000 2001 2002 2003 2004 2005 381 460 506 435 585 616
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Acknowledgements
Urban Indian SDPI Data
Indian Health Service: Kelly Acton, MD, MPH, FACP; Karen Sheff, MS SIHB Urban Indian Health Institute: Jessica Folkman, MPH, Susan Mathew, RN, MS, CNS, CDE; Maile Taualii, MPH; Ursula Tsosie, MSPH
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Source:labresultsforlife.org
