A new approach for managing diabetes in an integrated health care system in the USA is highly successful in improving the access to essential education about the management of this chronic condition and quality of diabetes care, in general. The programme was comprehensive and involved both patients and providers. It consisted of practice guidelines, medical screening, provider reports, diabetes education, focused clinic visits, easy access to care and reminder systems. Results indicated significant improvements in preventive screening, improved access to diabetes education, and lowering of HbA1c values (Friedman et al 1998).
