Monday, June 16, 2025
6/16/2025
Special Diabetes Program for Indians (SDPI) - The Pueblo de San Ildefonso is a federally recognized Native American Tribal Government—one of the nineteen Pueblos still in existence in New Mexico. The pueblo is located on the meadow mesas and canyon systems of the eastern Jemez Mountains of north Central New Mexico. The population of San Ildefonso is approximately 820 people. The Indian Health Services (IHS) Santa Fe Service Unit Hospital and the Santa Clara Clinic provided a wide rage of medical services to the Pueblo's residents. According to the Centers for Disease Control and Prevention (CDC), approximately 86 million Americans age 20 and older (37%) have prediabetes (i.e., blood glucose levels higher than normal but not high enough to be diagnosed with diabetes) and 90% of those with prediabetes do not know they have it. Obesity is strongly associated with both type 2 diabetes and prediabetes. Interventions to prevent or delay the development of type 2 diabetes have the potential both to improve individual health and quality of life through disease avoidance (e.g., eye, kidney, and nerve damage; strokes; heart attacks) and to save the health care system substantial medical costs by reducing the incidence of type 2 diabetes and its associated complications. Without such interventions, it is estimated that 15-30% of individuals with prediabetes will develop type 2 diabetes mellitus (DM) within five years. In most of the studies conducted with adult AI/NAs, prevalence rates of obesity/overweight are higher than the respective U.S rates for all races combined, with Native Americans being twice as likely as whites to have type 2 diabetes. Lifestyle changes to reduce obesity and obesity-related inflammation have been shown to reduce symptom burden in this population. Lifestyle interventions delivered via mobile applications are on the rise in order to provide low cost, personalized options that capitalize on efforts to promote self-management and health behavior change. Self-management strategies (e.g., healthy diet and exercise), as part of a lifestyle intervention, have been associated with improved outcomes in cancer populations; however, these programs rarely included personalization to patients’ preferences, and have had limited success in demonstrating long-term adoption of health behaviors. Out of 820 people, about 47 people have a documented diagnosis of diabetes. These community members with a diagnosis of diabetes are in a dire need access to physical activity participation and education, better nutritional education, better monitoring of cardiovascular risk factors such as hypertension, poor nutrition, stress, tobacco use, and medication routine adherence. About the need assessment or user population, estimated 679 American Indian/Alaskan Native received health services from local IHS clinics, out of which 35 were diabetics. In preventing and/or treatment of diabetes at San Ildefonso Pueblo, there are four common challenges, which has been quite common in the past. These challenges include: (a) recruiting and retention of qualified staff, (b) patient participation, (c) transportation, and (d) perception of inevitability of developing diabetes no matter what the community members do. For FY23, San Ildefonso Pueblo has chosen “Blood Pressure Control” as their best practice for SDPI Program with the following proposed activities or services: (a) Biweekly Blood Pressure checks and promoting blood pressure self-monitoring; (b) Hypertension Education, (c) Nutrition and Diabetes Education, (d) Provide access to physical activities/education and stress management education, (e) Compliance with medication, and (f) Obesity Management and Reduction. Based on these proposed activities, this best practice will target a population of 47 people with their ages 40 and above for treatment. Patients with diabetes who have blood pressure <140/<90 will also be encouraged to follow the lifestyle modification to prevent them from getting high blood pressure.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).