In 1986, the Indian Health Service (IHS) Division of Diabetes Treatment and Prevention (DDTP) developed its first IHS Standards of Care for Diabetes.  Over the past 20 years, these guidelines have helped health care professionals provide excellence in diabetes care to American Indians and Alaska Natives (AI/AN).

To keep these guidelines current with the ever-changing field of diabetes care, the IHS DDTP and the Area Diabetes Consultants (ADCs) have developed the 2006 IHS Standards of Care for Patients With Type 2 Diabetes.  The guidelines:

·        Address the unique aspects of care for AI/AN people.

·        Enable health care professionals and other members of a diabetes care team to offer consistent quality diabetes care to AI/AN adults with type 2 diabetes.

·        Have been developed using a consensus process backed by literature review, guided by consultation with scientific experts, and refined with input from health professionals from many disciplines.

·        Reflect and support the concept of a team approach to diabetes care in our facilities and the communities that surround them.

·        Should be used in the context of the whole patient, not just a single disease entity.

·        Should be used in the context of a model of care (such as the Chronic Care Model) that includes elements, which in combination, foster productive interactions between informed patients—who play an active role in their care—and providers with resources and expertise. 

The IHS DDTP and ADCs endorse and support the current American Diabetes Association (ADA) Clinical Practice Recommendations as the foundation of excellence in diabetes.  The 2006 IHS Standards of Care for Patients With Type 2 Diabetes differ from the ADA clinical practice recommendations by bringing focus to the specific care issues of AI/AN people with diabetes, placing greater emphasis on the prevention of complications that are most notable in the AI/AN population.  

As such, these guidelines do not include clinical guidelines on the care of people with type 1 diabetes.  The ADA Standards of Medical Care in Diabetes—2006 thoroughly address the issues of the diagnosis and treatment of type 1 diabetes, and providers are encouraged to refer to these for guidance.  (The ADA Standards of Medical Care in Diabetes—2006 are available online at:  http://care.diabetesjournals.org/cgi/content/full/29/suppl_1/s4.)