Catherine Cuellar, 90.1 reporter: When Gloria Mendias of Carrollton went the Central Dallas Ministries community clinic a year ago for a doctor's appointment, she thought back pain was her problem. It turned out to be a symptom.

Gloria Mendias: [translation] They told me my kidneys were damaged because of high blood sugar.

Cuellar: Most of the patients at the clinic are like Mendias. They speak Spanish. They have no insurance. And they are low-income. If they have diabetes, they meet quarterly with Helen Rodriguez-Farias, a community health care worker for CoDE - the community diabetes education program.

Helen Rodriguez-Farias, CoDE: A lot of the people who have had diabetes don't know what type of diabetes they have, and they really don't know what could happen. I teach the importance of having their blood sugar controlled, and why. So in the long run if they don't keep their blood sugar controlled what could happen is they can lose their eyesight, they can end up having to be on dialysis, heart problems.

Cuellar: Rodriguez-Farias has a GED and state certification as a community health worker. In other diabetes programs across the country, she'd be an assistant to a doctor or a case worker. This Community Diabetes Education program is unique because she is the case manager and liason between clients and their doctors. Dr. Beth Prezio, who helped create CoDE, says that so far, patients in this program have improved as much or more than those managed by doctors.

Dr. Elizabeth Prezio, CoDE: I think the patients are afraid to admit to a higher level person that there's a problem at home. They don't want the doctor to think that there's something amiss. They want to appear to be "good." Whereas, when they get in Helen's office, Helen's viewed more as an equal, someone from the area, the community, someone familiar. So they're not afraid to discuss their social issue with their spouse, their issues with their children, their illnesses in their family, and even such personal issues as husband and wife relations.

Cuellar: Rodriguez-Farias has snack packages, measuring cups, and plastic toy eggs and potato chips on the walls of her office to show proper portion sizes.

Rodriguez-Farias: Most of the patients I see here are ones that come from Mexico or speak Spanish and they have a really low education level, so that might be just went to school to second grade. Most of them can't read so it's really hard for them to understand stuff. A lot of times I have to go through things over and over and over with them again. For our patients it's easier to visualize something instead of me just telling them, it's easier for them to see that and to follow it.

Mendias: [translation] She told me my blood sugar would not be controlled unless I exercised. So I began to walk for 45 minutes to an hour every day. One of the things I do now is to eat less. Before I used to eat a full plate of food. Now I eat 1/4 of what I used to eat. I lost 40 pounds and feel very good.

Cuellar: It's not only good for the patient, it's good for the clinic as well. This kind of effective case management is also low-cost. That means non-profit health clinics, who often provide indigent care in north Texas, could help even more patients suffering from diabetes.
For KERA 90.1, I'm Catherine Cuellar.

More online:
Central Dallas Ministries CoDE website