St. Francis Medical Center
Monroe, La.

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The St. Francis Medical Center Diabetes & Nutrition Center (D&NC) is an American Diabetes Association-recognized self-management education facility located in Monroe, La. Diabetes is a problem that is plaguing the people of Louisiana, and Northeast Louisiana reports some of the highest numbers in the state. Diabetes management is a vital tool in achieving Healthy People 2020 goals by helping patients meet their diabetes management goals and keeping patients with pre-diabetes and multiple risk factors from developing the costly complications of this disease.

Diabetes and obesity disproportionately affect the poor. The D&NC helps patients manage their diabetes, overcome obesity and address risk factors for other complications before they become costly — and potentially deadly — problems. According to a 2008 Professional Research Consultants, Inc., (PRC) Community Health Assessment sponsored by the Louisiana-based Living Well Foundation, 41 of every 100,000 deaths in Louisiana and 25.1 of every 100,000 deaths in the United States as a whole are due to diabetes. This ranks Louisiana as the number one state for deaths due to diabetes. However, these numbers seem low when compared to the 71.8 of every 100,000 deaths in Ouachita Parish that are attributed to diabetes. Additionally, in 2005, 269,000 adults in Louisiana had been diagnosed with diabetes, and it is generally estimated that up to one-third of diabetics are undiagnosed. In 2006, the total cost of diabetes to Louisiana was approximately $2.431 billion. Nationwide one of every 10 health care dollars is attributed to diabetes (ADA Economic Costs of Diabetes in the U.S. in 2007, 2008).

The target population of the D&NC is newly diagnosed diabetic patients, existing diabetes patients who have poor control of their blood sugar and mothers with gestational diabetes. The secondary target population is overweight people in need of nutritional counseling and patients with lipid abnormalities and a high risk for cardiovascular disease. Additionally, the center helps high-risk patients such as gestational diabetics have positive outcomes. Often, these patients are reliant on the Medicaid system for their care, and the reimbursement structure for Medicaid patients seeking diabetes self-management education has not caught up to the reality of the growing need. However, the D&NC is dedicated to serving these patients in order to eliminate their barriers to care and help them have a healthy pregnancy.

With an infant mortality rate of 10.6 per 1,000 live births in Ouachita Parish (compared to a rate of 7 per 1,000 for the United States), the area experiences some of the highest infant mortality and premature birth rates in the country. Through the program's outreach to gestational diabetics, 89 mothers in fiscal year 2009 were assisted, with an estimated 90 percent of babies being born with a weight of less than nine pounds. Expectations are to continue impacting the positive outcomes for gestational diabetics as the center strengthens its ties with local health care professionals and reports throughout the community how diabetes management has positively affected the lives of mothers and babies