Diabetes outcomes in the Indian health system during the era of the Special Diabetes Program for Indians and the government performance and results act

Charlton Wilson, Susan Gilliland, Theresa Cullen, Kelly Moore, Yvette Roubideaux, Lorraine Valdez, William Vanderwagen, Kelly Acton

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Abstract

Objectives. We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system. Methods. We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care and Outcomes Audit. Results. Adjusted mean Hemoglobin A1c (HbA1c) levels (7.9% vs 8.9%) and mean diastolic blood pressure levels (76 vs 79 mm Hg) were lower in 2001 than in 1995, respectively. A similar pattern was observed for mean total cholesterol (193 vs 208 mg/dL) and triglyceride (235 vs 257 mg/dL) levels in 2001 and 1995, respectively. Conclusions. We identified changes in intermediate clinical outcomes over the period from 1995 to 2001 that may reflect the global impact of increased resource allocation and improvements in processes on the quality of diabetes care, and we describe the results that may be achieved when community, health program, and congressional initiatives focus on common goals.

Original languageEnglish (US)
Pages (from-to)1518-1522
Number of pages5
JournalAmerican journal of public health
Volume95
Issue number9
DOIs
StatePublished - Sep 1 2005

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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