Choctaw Nation Diabetes Wellness Center Program information Choctaw Nation of Oklahoma Choctaw Nation Diabetes Wellness Center “Happy Heart” Cardiovascular Disease Risk Reduction Project *The clinical measures listed on these documents were used by the programs over the past 10 years and were current at their time of use. However, these example documents are not intended to serve as current clinical guidelines. Programs using these documents will need to ensure the clinical measures are current for their intended use.

The Facts Every 33 seconds cardiovascular disease will claim someone’s life. It results in more deaths than all forms of cancer combined. Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die.

Known as a silent killer because it often has no warning signs until a stroke or heart attack ensues.

Heart Attack is the leading cause of death in both men and women in the United States today.

People who have type 2 diabetes have a four times greater chance of dying of a cardiovascular event, such as heart attack or stroke.

“Happy Heart”, CVD Grant Awarded through a competitive grant process 30 Grantees across the United States 5 year grant beginning October, 2004 – September, 2009 Extended an additional year, 2010 We will apply for 2 additional years this summer.

Who Can Participate Native Americans/Alaska Natives Diagnosis to Type 2 Diabetes Age 18 and older Exclusion Criteria: Pregnancy Active alcohol or substance abuse by provider judgment End Stage Renal Disease on Dialysis Any other significant medical conditions or circumstances that may adversely affect participation

Ways to Reduce the Risk of CVD Stop Smoking Keep Blood Pressure Within Normal Range Maintain Blood Glucose Levels Within Normal Range Keep Cholesterol Levels Within Range Exercise Daily (at least 30 minutes) Adhere to Low Sodium/Low Fat Diet

Target Ranges Blood Pressure  Below 130/80 LDL Cholesterol (Bad) – HDL Cholesterol (Good)  Men 40 or greater  Women 45 or greater Triglycerides  Less than 150 A1C  Less than 7%

Participant Benefits Monthly case management visits until target ranges are reached, then visits will be quarterly. Nurse Case Managers assist with management of care, setting goals and are available to answer participant questions in person or by telephone. Physical Activity Leader (PAL) to assist with developing and maintaining a personal exercise plan. Consultation with a Registered Dietician and assistance with personal meal planning. Group and individual diabetes and cardiovascular disease education classes. Laboratory test performed regularly. Family participation is encouraged through community events.

Minutes of Physical Activity Each Week 70 60 60 50 50 46 43 38 40 Baseline 1st Annual 2nd Annual 3rd Annual 29 30 20 21 20 16 14 17 17 11 11 10 7 0 minutes 1-89 minutes 90-149 mintues >150 minutes

Mean HbA1c at Each Assessment 8.2 8 7.8 7.6 7.4 7.2 7 6.8 6.6 8.1 7.9 7.8 7.7 7.6 7.6 7.5 Baseline 1st Annual 2nd Annual 3rd Annual 7.4 7.2 7.2 7.1 7.1 Female Male Total

Mean LDL at Each Assessment 120 100 80 Baseline 1st Annual 2nd Annual 3rd Annual 60 40 20 Female Male Total

Mean Systolic Blood Pressure 132 130 128 Baseline 1st Annual 2nd Annual 3rd Annual 126 124 122 120 118 Female Male Total

Mean Diastolic Blood Pressure 76 75 74 73 72 71 70 69 68 Baseline 1st Annual 2nd Annual 3rd Annual Female Male Total

Mean BMI 38 37 36 35 34 33 32 31 30 Baseline 1st Annual 2nd Annual 3rd Annual Female Male Total

Current Participation We have recruited 265 participants. Base line examinations have been performed on 197 participants. We currently have 186 active participants.