The Otoe-Missouria Special Diabetes Program is funded through the federal Special Diabetes Program for Indians, created in 1997 to address the growing epidemic of diabetes in American Indian and Alaskan native communities. Cheryl Glover, coordinator for the Otoe-Missouria Special Diabetes Program, provided a list of the 35 states that get funding through the federal program. Among them, only Arizona gets more money than Oklahoma. Last year, tribes in Oklahoma got $18.2 million. “Oklahoma is one of the higher-population states of all the different tribes,” Glover said. According to the National Indian Health Board, American Indian and Alaska native populations have the highest rates of Type 2 diabetes — 2.8 times that of the general population. In 1963, the National Institutes of Health’s Pima Indian Study recognized a diabetes epidemic among American Indians. In 1974, the Diabetes Mellitus Inter-agency Coordinating Committee was established by Congress, and in 1976, the Indian Health Service National Diabetes Program was created by Congress. In 1986, the Indian Health Service Standards of Care were developed, followed in 1996 by the American Diabetes Association created the Awakening the Spirit national advocacy team. In 1997, Congress created the Special Diabetes Program, consisting of the Special Diabetes Program for Indians and the Special Type 1 Diabetes Research Program. Each program was given $30 million in funding for five years. In 1998, Congress extended the programs an additional three years, and increased funding to $100 million for each program per year. In 2000, IHS established best practices based on data from SDPI. In 2002, Congress extended the program another five years, and increased funding to $150 million for each program. In 2003, the NIH Diabetes Prevention Program Study yielded scientific evidence Type 2 diabetes can be prevented or delayed. In 2004, Congress directed the program to initiate demonstration projects that focus on diabetes prevention and cardiovascular disease risk reduction. Congress extended the programs in 2008, 2009 and 2010. SDPI has given a strong return on investment of federal money. Among clinical results the program has seen, blood-sugar levels have improved, risk of cardiovascular disease has been reduced and diabetes-related kidney disease has been slowed. Additionally, prevention and weight-management programs for children and youth are used by more than 80 percent of SDPI grant programs; communities have seen significant increases in nutrition services, walking and running programs, and adult weight-management programs; and culturally appropriate diabetes education activities are in use by more than 90 percent of the programs. Despite the success of the SDPI program, its continuation is an open question. “SDPI is set to expire in September 2013 unless Congress once again takes action to extend the program,” the NIHB website reads. “And, as in past renewal efforts, we are urging Congress to renew the program early so that successful programs can continue uninterrupted, and talented staff will remain in communities and continue to provided needed services.”
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