In the midst of a reorganization at SSM St Mary’s Health Center, another ADA-recognized diabetes education program in the St Louis area is on the chopping block. A couple days ago rumors started spreading that the St. Mary’s program was going to be eliminated. Rob Shelton, Director of Marketing for the hospital, said that St. Mary’s was going to “scale back outpatient services to the diabetic population.” Per Mr. Shelton, one vacant position in the diabetes education department is not going to be filled, but the hospital has not yet reduced staff in the area. Clearly, the future of diabetes education at St. Mary’s is uncertain. If (or when) St. Mary’s eliminates outpatient diabetes education, they will join the ranks of Barnes-Jewish Hospital and Missouri Baptist who also made the similar decisions to shutter outpatient diabetes education services in the past 2 years. Financial reasons (and reallocation of resources) were cited in those program shut-downs. Access to diabetes self-management education is a big problem in the St. Louis region…and becoming a bigger one. Where can patients with diabetes turn for reliable information to build their self-management skills? Medicare only covers such education services provided by ADA-recognized providers… and there are less of those today than there were a few years ago. Of course, the number of people with diabetes needing education to prevent complications and costly hospitalizations is on the rise.