After learning that her son had been arrested for driving an electric bike while intoxicated on Oct. 19, Nora Gallmeyer went to the Ramsey County jail to make sure the staff was aware of his Type I diabetes.

Despite that warning, Randy Gallmeyer never received the necessary blood-sugar tests before he was found on the floor of his cell with a faint pulse on Oct. 21. He died at a hospital a day later.

Gallmeyer's very preventable death illuminates the challenge of providing effective health care in county jails. It also reveals the need for more medical training for the correctional officers who often serve as a safety net for ailing inmates. Minnesota counties are facing more complex illnesses in their growing jail populations, and a statewide strategy is needed to address that trend.

Gallmeyer was one of more than 500 inmates in the Ramsey County jail the weekend he became ill. He refused two attempts by jail nurses to check his blood-sugar level, and officials have said another nurse who had been on the job a month failed to attempt the test during her shift. The jail had no overnight nursing shift, so by the time he was found Gallmeyer's blood sugar had gone untested for more than 24 hours.

Those trained in diabetes management know that uncooperativeness is a classic symptom of low blood sugar. Gallmeyer should have been taken to a hospital and forced to undergo testing and treatment.

Protocols were in place to do just that, but Gallmeyer died when the people responsible for his care -- including the officers monitoring his cell -- failed to recognize the seriousness of his condition.

A similar case in Pennsylvania in 2000 led to a class-action lawsuit in which 256 diabetics sued the city of Philadelphia alleging that they became ill after being denied adequate care while jailed. Terms of the settlement included significant changes in the care and monitoring of jailed diabetics, in addition to more training for officers.

The correctional system in Minnesota is a maze of local and state agencies with varying degrees of responsibility for health care, but correctional health is primarily operated and funded at the county level. That's where the Gallmeyer case can have the most impact.

Local officials should review staffing, training and procedures to ensure that health care is effectively administered. The state Department of Corrections and Health Department should lead the way in demanding quality care in state facilities.

Ramsey County took a positive step this week and added an overnight nursing shift. It's too late for Randy Gallmeyer, but it may be the first of many constructive outcomes from his death.