It's probably no surprise that Louisiana, best known for its high-calorie, artery-clogging cuisine, ranks first in the nation for having the highest per capita diabetes mortality rate.
The disease accounts for 36 of every 100,000 deaths in Louisiana. It's a number that has state health officials' focus as they mark National Diabetes Prevention Month in November.
The prevalence of diabetes in Louisiana has steadily increased from 5.2 percent in 1997 to slightly more than 10 percent in 2007.
Diabetes is a disease in which an individual's blood glucose, or sugar levels are too high. It can lead to blindness, heart disease, kidney disease, nervous system disease, as well as strokes and is a leading cause of lower-limb amputations.
Yet many people have the disease for four or five years before receiving a diagnosis, said Cynthia Watson, a nurse practitioner with LSU University Medical Center Lafayette's diabetes clinic.
"At the rate that diabetes is increasing and at the rate of obesity, we can expect that by 2050 as many as 50 percent could have diabetes," Watson said. "So young children now will be middle-aged adults in 40 years."
Nationwide, nearly 24 million people in the United States are affected ? an increase of more than 3 million in about two years ? meaning almost 8 percent of the nation's population has diabetes, according to the Atlanta-based Centers for Disease Control.
From 10 percent to 20 percent of cases fall in the Type-1 category ? formerly called juvenile diabetes ? an autoimmune disease in which the body destroys insulin-producing cells. Currently there is no known way to prevent Type-1 diabetes.
Type-2 diabetes is often genetic, but it's preventable, she said.
"Neither is worse," Watson said. "There is no good type of diabetes. Both are very treatable."
Preventing and treating Type-2 starts with education, she said. UMC has a program that is recognized by the American Diabetes Association.
Yet because diabetics may be losing their sight, or may have nerve damage in their feet or legs, they lose productivity or have mobility problems. Therefore, they can't work. Going without a job could mean they don't have medical insurance to pay for education or treatment.
(2 of 2)"When you can't work, you can't pay for care, so the burden of care falls on the public," she added.
But there's a bright side. UMC's program of communication and education for physicians who treat diabetes and other diseases is about 12 years old. It has had beneficial results, said Larry Dorsey, the hospital's administrator.
It was set up for all of the hospitals within the LSU system and "through it physicians collaborate with other physicians."
"They study national trends and national literature about each of the diseases and they educate our providers on the best ways to treat diseases," Dorsey said.
The net result over the years has been to keep hospital admissions down, which in turn saves the state money.
Louisiana is also recognized as one of the last states, if not the only state, to support a charity hospital system. It isn't called that anymore. However, the state does provide funding for care for the indigent population, and UMC is a recipient of such funding. At least for now.
"There will be cuts in health care for the indigent," he said, referring to a state budget deficit in the hundreds of millions.
"We don't know if our hospital will be closed, but possibly some could get closed next year. We're hoping for the best," he said.
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