These successes were formally recognized recently with a Special Recognition Award from Dr. Yvette Roubideaux, director of the IHS, “for innovative and outstanding teamwork that successfully demonstrated cardiovascular disease risk reduction in American Indian and Alaska Native communities.”

“It is true that we face significant challenges in dealing with the diabetes epidemic, but the belief is strong among American Indian and Alaska Native communities that they are on the path to a diabetes-free future,” Valdez said.

Work is Ongoing

Even with successes such as the demonstration projects, IHS is not resting on its laurels, said Valdez. Best practices are updated every two years, with the 2011 list not only adding the prevention and treatment best practice, but also incorporating updates to the others. “We try to update the best practices approximately every two years to ensure that they are up to date and provide the latest science and benchmarks for grant programs to use as they work to improve their programs and the health of their communities,” she explained.

The most obvious type of change, Valdez continued, has to do with updates in clinical standards of care from other organizations. So, for example, if the American Heart Association changes the definition of “good” blood pressure, the IHS standards need to reflect that.

IHS also has pioneered in standard development, said Valdez, noting, “In 1986 the IHS Division of Diabetes developed the IHS Standards of Care for Patients with Type 2 Diabetes, the first set of national clinical guidelines for diabetes care published by any U.S. organization. Over the past 25 years these guidelines have helped healthcare professionals provide excellent care to AI/AN people with diabetes using evidenced-based strategies.” Research has shown that using these strategies for controlling glucose, blood pressure and lipids reduces the risk of diabetes complications and improves patients’ quality of life.

In order to track the care provided using the Standard of Care, the IHS Division of Diabetes developed the Diabetes Care and Outcomes Audit — a process for assessing diabetes care and health outcomes for AI/ANs with diagnosed diabetes — also in 1986. “This allows local communities to identify areas for improvement and implement strategies to work towards the goal of providing the highest quality of care, as outlined in the Standards of Care,” Valdez said.

The bottom line, she added, is that interest in diabetes prevention is “very high,” and, now that the new best practice has been implemented, IHS is working on developing information on how to start a basic prevention program, which will include educational resources and tools.