Several activities are included in this program. One activity involves a collaboration with the Diabetes Center of Excellence (DCOE) at Phoenix Indian Medical Center (PIMC). We collected and analyzed data from a quality improvement project in which nurse case managers were empowered to adjust antihyperglycemic medications in patients with diabetes to more rapidly optimize glycemic control in a system that does not have sufficient capacity for primary care providers to meet its patient care needs. A manuscript regarding this aspect of the project has been accepted for publication. We have also collaborated with PIMC to develop a protocol for a clinical trial to examine the impact of an intensive lifestyle intervention, delivered in a group care setting, on weight gain and glycemia in pregnancy and on birth weight. We hope to have all approvals completed and begin collecting data under this protocol during FY 2010. We have begun a project with the Phoenix Indian Medical Center and Joslin Vision Network to determine factors responsible for successful implementation of a telemedicine program to identify patients with diabetic retinopathy within the Indian Health Service.

Project Start
Project End
Budget Start
Budget End
Support Year
3
Fiscal Year
2009
Total Cost
$289,690
Indirect Cost
City
State
Country
Zip Code
Looker, Helen C; Krakoff, Jonathan; Andre, Vickie et al. (2010) Secular trends in treatment and control of type 2 diabetes in an American Indian population: a 30-year longitudinal study. Diabetes Care 33:2383-9
Curtis, Jeffrey; Lipke, Suzanne; Effland, Shirley et al. (2009) Effectiveness and safety of medication adjustments by nurse case managers to control hyperglycemia. Diabetes Educ 35:851-6
Kim, Nan Hee; Pavkov, Meda E; Looker, Helen C et al. (2008) Plasma glucose regulation and mortality in pima Indians. Diabetes Care 31:488-92