| Lee Ann Griffin is a warrior for the Choctaw | | | | years, have a minimum of 1,000 hours in diabetes |
| nation. Not the kind of warrior you'd imagine, | | | | self-management experience, and have current |
| Griffin RN, CDE (certified diabetes educator) | | | | employment as a diabetes educator a minimum |
| battles diabetes, a disease whose numbers are | | | | of four hours per week. |
| growing. Her weapons are education, medical | | | | Griffin sees 2-6 patients per day. "We discuss |
| supplies such as glucometers and test strips to | | | | nutrition, exercise, medications and complications in |
| check blood sugar levels, medicine and lots of | | | | our sessions," Griffin stated. Physicians refer most |
| determination. | | | | of her patients, but some patients make their |
| Oklahoma ranks second in the number of Native | | | | own appointments. |
| Americans or American Indians. People of Native | | | | "The Choctaw Nation is fortunate to have an |
| American heritage have a higher risk of | | | | Endocrinologist (a specialist in diabetes) at the |
| developing diabetes. According to the Centers for | | | | Wellness Center in Talihina. I work with the |
| Disease Control, the largest ethnic group of | | | | doctors and do their lab work. We use a lab test, |
| diabetics in Oklahoma, 2000-2001, was the Native | | | | the hemoglobin A1C, to see how the patient is |
| American population; 10.1% were diabetics. Also, in | | | | doing. This blood test measures blood sugar levels |
| 2000 Oklahoma ranked 15th in the nation in | | | | for approximately 90 days. We want the A1C |
| deaths from diabetes. | | | | levels to be between 6.5-6." (Recently the |
| Griffin, a member of the Choctaw Tribe, is a | | | | American Diabetes Association changed their |
| Community Diabetes Educator based out of the | | | | recommended A1C levels for diabetics from |
| Choctaw Nation clinic in McAlester, Oklahoma. She | | | | >7 to 6.5-6.) Most doctors want their diabetic |
| is part of the Choctaw Diabetes Wellness Center, | | | | patients to have an A1C every 3-6 months. |
| which is located in Talihina, Oklahoma. The | | | | Griffin gives her patient's glucometers and test |
| Diabetes Wellness Center offers complete | | | | strips. She teaches them how to use the |
| services for diabetics. The staff includes a | | | | glucometers and makes them demonstrate they |
| physician who is board certified in Endocrinology, | | | | can use them correctly before the end of training. |
| Diabetes and Metabolism, a physician's assistant, | | | | Patients can also get their diabetes medications |
| and a master's level Nurse Practitioner. The | | | | and supplies at the clinic. Griffin admits that some |
| Center also houses a fitness center with trainers | | | | of the newer medications for diabetes are not on |
| who help participants with an individualized fitness | | | | the clinic's Drug Formulary. |
| program. Besides Griffin, the Diabetes Wellness | | | | She still sees a lot of complications from diabetes |
| Center employs four other Community Diabetes | | | | such as leg amputations. There are more young |
| Educators. | | | | adults with Type 2 diabetes, which used to occur |
| Griffin has individual appointments with patients on | | | | mostly in middle-aged people. |
| Mondays at the McAlester clinic. She sees patients | | | | Griffin and the other diabetes educators will go |
| of all ages who have a CDIB (certificate of | | | | wherever they're invited such as doing diabetes |
| degree of Indian blood) card that shows | | | | screening at health fairs, senior citizen's centers, |
| membership in any recognized American Indian | | | | and the Choctaw Nation Housing. The educators |
| tribe. She also sees employees who make | | | | are also trying to reach the younger generation. |
| appointments. | | | | "We have a wellness program in the Choctaw |
| "I'm proud that our employees get good care. In | | | | Head Start programs. We are trying to catch the |
| Talihina there is good attendance in the Employee | | | | parents of the students," Griffin said. |
| Wellness Group." | | | | The Choctaw Nation sponsors a program to |
| Griffin is delighted with the new, modern Choctaw | | | | teach fifth graders about diabetes. The diabetes |
| Health Clinic, which replaced the old one in | | | | educators go to 36 different elementary schools. |
| McAlester. "This clinic opened in July, 2007. We | | | | "We developed the program to teach 5th graders |
| also have clinics in Stigler, Poteau, Broken Bow, | | | | what diabetes is on their level. We discuss risk |
| Idabel Hugo, and a clinic opened in Atoka in 2008. | | | | factors, and signs and symptoms of diabetes and |
| Talihina is home to the hospital and the specialty | | | | also stress two healthy habits: exercise and |
| clinics." | | | | nutrition." |
| Griffin has worked for the Choctaw Nation since | | | | The students are taught food portion sizes and |
| 2001. | | | | how to read the nutrition labels on boxes and |
| "One day I was handed a blank piece of paper | | | | cans. "Food labels are one of the biggies," Griffin |
| and was told to plan a Diabetes Wellness Program. | | | | said. The educators emphasize portion control and |
| The program is funded by a federal grant and a | | | | teach easy visuals such as the palm of hand |
| matching grant from the Choctaw Nation." | | | | equals one serving of meat, and the thumb is |
| Designing the program happened by trial and | | | | equal to one ounce. |
| error. She saw diabetic patients and tried out | | | | In Griffin's classes, she doesn't stress weight. "I |
| different ideas to see which ones worked best. | | | | try to stress serving sizes, slow weight loss, and |
| "We tried doing group sessions, but we had poor | | | | increased exercise. Walking is a great way to |
| attendance, and the individual sessions worked | | | | exercise." |
| better." | | | | Additional health information is available on the |
| Griffin took a national exam and received her | | | | Internet at the Choctaw Nation website, then click |
| credentials from the National Certification Board | | | | the link for the Health Services Authority. |
| For Diabetes Educators to become a certified | | | | When asked about the future of diabetes |
| diabetes educator (CDE) in 2005. In order to take | | | | treatment, Griffin responded, "The future of |
| the exam, medical professionals such as doctors, | | | | diabetes is that treatment will become more |
| registered nurses, clinical psychologists, | | | | aggressive. It comes down to lifestyle, prevention, |
| optometrists, and certified dieticians must be | | | | and wellness. |
| employed in diabetes self-management for two | | | | |