Abstract
The incidence and prevalence of diabetes mellitus in the Omaha Nation population is epidemic (Wiedman, 2012). The Omaha Native American/ Diabetes Mellitus relationship is corollary to indigenous populations enveloped by adherence to European-American diets, and subsequent medical challenges. Anthropological-based dietary requirements predicated by the indigenous gastric biome, are currently incohesive with mainstream evidence based practice for diabetic management, and food availability per commodity allowance. Historical trauma and psychosocial stresses promote inactivity and an unhealthy modern diet, magnifying the concern. Failure to recognize this lack of concordance detracts from diabetic education modalities leading to efficacious positive outcomes in successful disease management. This project applies subjective principles from Pender's Health Promotion Theory (Pender, Murdaugh, & Parsons, 2014) to diabetic education, empowering and promoting self-resilience and intrinsic ownership for chronic disease management. Dietary teaching based on historically indigenous diets, conforming with American Diabetic Association (ADA) principles, was introduced to diabetics of the Omaha Native American tribe presenting to the Carl T. Curtis Health Center for care, using the Native American Diabetic Nutritional Worksheet (NADNW). Efficacy of diabetic teaching was objectively measured by comparison of serum hemoglobin A1c (HgbA1c) levels pre-and post-intervention; qualitative metrics of indigenous dietary food incorporation were also queried. Results indicated no statistically significant alteration in HgbA1c after educational intervention using the NADNW. Reservation poverty and patient-clinician relationships were identified as variables critically determinant of significance among participants.