SDPI Overview

Congress established the Special Diabetes Program for Indians (SDPI) in 1997 as part of the Balanced Budget Act to address the growing epidemic of diabetes in American Indian and Alaska Native (AI/AN) communities. The Special Diabetes Program for Type 1 Diabetes (SDP) was established at the same time to address the opportunities in type 1 diabetes research. Together, these programs have become the nation’s most strategic, comprehensive and effective effort to combat diabetes and its complications. SDPI currently provides grants for 301 programs in 35 states.

At a rate approximately 2 times the national average, AI/ANs have the highest prevalence of diabetes. In some AI/AN communities, over 50% of adults have been diagnosed with type 2 diabetes and AI/ANs are 1.8 times more likely to die from diabetes.

SDPI is changing these troubling statistics with marked improvements.

This success is due to the nature of this grant program to allow communities to design and implement diabetes interventions that address locally identified community priorities. Tribal leaders have identified community adaptability to be a strong element of SDPI’s success. They have shared that the ability of the community to make local level decisions, choose best practices, and adapt the program to be culturally appropriate has been vital to its success.

On December 21, 2020 Congress passed a three-year renewal of SDPI. The renewal was included in a larger spending package to fund the federal government. This funding agreement followed 15 months of congressional negotiations in which SDPI was renewed for six short term extensions. The uncertainty Tribes experienced as these negotiations continued speaks to the need to secure long-term funding for the successful program. Additionally, the reauthorization did not include increased funding for SDPI. The program has been flat-funded at $150 million annually since 2004, despite national efforts to advocate for an increase to $200 million by Tribes and NIHB. The reauthorization also does not allow for an amendment permitting Tribes and Tribal organizations to receive SDPI awards through Title I contracting or Title V compacting agreements under the Indian Self-Determination and Education Assistance Act (ISDEAA). SDPI currently has funding through December 18, 2023.

Please visit the "For Advocates" section of this website to learn how you can help in continued efforts to promote this lifesaving program.