Cherokees fight diabetes by thinking in small steps

Instead of initiating a sweeping program in its 14-county jurisdiction in Northeastern Oklahoma when it received a large increase in diabetes-related federal funds six years ago, the tribe went the opposite direction.

It now assists community centers and schools financially and reaches out elsewhere, signing up as many people as it can to walk, run, dance, hike, and learn to cook and eat better.

"I wish I knew the amount of money we spent — direct medical expenses — on diabetes; I don't have the number for that, but it's huge,” said Diabetes Program Director Teresa Chaudoin, who came to work for the tribe in 2001, after completing a master's degree in public health at Johns Hopkins University in Baltimore.

Loosely described, the tribe's diabetes program has 15 components, including testing the blood sugar of anyone at risk of diabetes — being American Indian is considered a risk factor — who visits the tribe's eight clinics, and fitness- and nutrition-related outreach and education.

Once a patient is diagnosed with diabetes, he or she is signed up for five sessions with a dietitian and others in the tribe's Diabetes Self-Management Education Program.

"We try to get everybody that is newly diagnosed into this program,” Chaudoin said, calling the approach "opportunistic screening.”