This month, we feature Frida Theros, RD, CD, CDE, who works with the Paiute Indian Tribe of Utah in Cedar City, Utah.
Is the Indian Health Service a public healthservice sponsored by the government? If so,how much has been budgeted for it in pastyears, this year and in future years?
Yes. The Indian Health Services (IHS) issponsored by the government. It includesa mandated government appropriationfor diabetes. The grants for diabetes varyfrom year to year and are based on the userpopulation.
What services does the Indian Health Serviceprovide to Native Americans with diabetes?
Services vary from tribe to tribe and dependon how each tribe decides to spend theirbudget. They basically go by “primary,”“secondary” or “tertiary” levelsof care. The decisions are made withvarying levels of freedom.For example, we are a 638tribe, which means we decidewhat services we do or don’toffer, while complying withregulations, and on how wespend our budget.
What particular tribes doyou work with?
The Paiute Tribe of Utah andany Native American whomeets the health service’srules of eligibility.
In addition to your homestate of Utah, what other states receiveservices from the Indian Health Service?
Basically all of them in the Continental UnitedStates and in Alaska.
Are services provided only to NativeAmericans on reservations, or are NativeAmericans living in cities, towns and ruralareas eligible for services as well?
All of the above, as long as they meet theeligibility criteria.
What is the current status of diabetes inthe Native American population, and whatchanges have you seen in the last few yearsas the type 2 epidemic has grown throughoutthe United States?
Type 2 diabetes is on the rise among theNative American population, as it is among thegeneral population. We are seeing type 2 at amuch younger age now, and the age is gettingyounger and younger. We had type 2 diabetesdiagnosed in a 6-year-old here last year.
How is the Indian Health Service helpingprevent Native American children from developingtype 2?
Through diabetes grants, a health promotion and diseaseprevention campaign and a lot of public health education.
What is the most rewardingaspect of your job?
Seeing clients who seek outmy help in managing theirdiabetes and watching themmake progress. They are avery private people, but theyhave opened their homes andtheir hearts to me and myservices. That is a great joy.
What does it take to be a good diabeteseducator?
Listen, listen and listen, with respect andempathy. Personalize the rules of diabetesmanagement. In other words, make the ruleswork for the person, not the person for therules.