Four years after MLK launched an intensive management program for the most at-risk patients, more than 80% of enrollees have seen blood sugar levels decline. More than 70% have brought their blood pressure under control.<\/p>\n
And diabetic-related amputations \u2014 which are painful and life-altering procedure that were the hospital\u2019s most common surgery <\/a>for years \u2014 have plummeted to zero for program patients.<\/p>\n No novel medications or treatments are behind these results, said Dr. Jorge Reyno, MLK\u2019s senior vice president for population health.<\/p>\n Dr. Edward Cardenas examines a patient with diabetes. <\/p>\n (Christina House \/ Los Angeles Times)<\/p>\n Rather, a relatively modest one-time grant has allowed the hospital system \u2014 whose service area includes some of L.A.\u2019s poorest and most disadvantaged neighborhoods \u2014 to provide the same level of care for its diabetic patients that people in wealthier areas would expect as standard.<\/p>\n \u201cWhat we\u2019ve demonstrated here is that we can get best-in-class care \u2014 we can even beat national benchmarks for care \u2014 if there\u2019s the appropriate commitment and investment. And that people\u2019s health doesn\u2019t have to be determined just by their zip code,\u201d Reyno said. \u201cBecause what we\u2019ve created here is not necessarily incredibly innovative. It\u2019s just what needs to be available \u2014 and is available in other locations.\u201d<\/p>\n Some 1.3 million people live in MLK\u2019s South Los Angeles service area. More than 90% are Black or Latino, and nearly 70% are either uninsured or have health coverage through Medi-Cal, Medicare or both. <\/p>\n Medi-Cal\u2019s low provider payment rates is one reason South L.A. has only one-third of the full-time physicians necessary to treat a population of its size \u2014 a 1,500-doctor shortage, according to MLK\u2019s research.<\/p>\n For many locals, MLK\u2019s emergency department is about the only place they can see a doctor, given the challenge they face securing a timely appointment with a physician who accepts their health coverage. <\/p>\n Roughly 123,000 patients arrived last year at the hospital\u2019s emergency department, which was designed to treat 40,000 people annually. About 40% were seeking primary care.<\/p>\n Emergency room physicians were diagnosing diabetes in severely ill people who did not know they had the disease and treating life-threatening complications for those whose disease had long gone unmanaged.<\/p>\n Patients arrived with gangrenous foot wounds that harried providers elsewhere brushed off as athlete\u2019s foot. Rates of diabetic ketoacidosis, a life-threatening complication that occurs when insulin levels are so low that cells can no longer convert glucose into energy, were three times that of the rest of Los Angeles County.<\/p>\n For many, care arrived too late to prevent one of the disease\u2019s most serious complications: amputation.<\/p>\n Nerve damage means a blister or pebble in the shoe can go unnoticed until it creates a serious wound. High blood sugar impairs immune function and narrows vessels that carry oxygen-rich blood, making it harder for skin to heal. Once serious infection sets in, amputating a foot or limb may be the only option to save a patient\u2019s life. Across the U.S., diabetes complications are responsible for roughly 80% of all non-trauma related amputations, according to the Centers for Disease Control and Prevention.<\/a> <\/p>\n Broaching amputation with a patient \u201cis really tough,\u201d Cardenas said. \u201cYou\u2019re taking such a big part of them away. It\u2019s identity, it\u2019s confidence, it\u2019s [the] ability to walk and do things for themselves. It\u2019s a huge, huge thing.\u201d<\/p>\n It\u2019s also costly. Diabetes cost $306.6 billion<\/a> in U.S. direct medical spending in 2022, the most recent year for which numbers are available, and foot ulcer-related issues were responsible for about one-third of that, said Dr. David G. Armstrong, director of USC\u2019s limb preservation program and the Southwestern Academic Limb Salvage Alliance.<\/p>\n![\"A](\"https:\/\/www.europesays.com\/ie\/wp-content\/uploads\/2026\/06\/1781440819_955_.jpeg\")
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