 Study settings include the CBOCs affiliated with the Cleveland Veterans Affairs Medical Center VAMC and involve primary care referrals to see diabetes specialists at the Cleveland VAMC. Inclusion criteria patientsN 282included: i current prescription of insulin or an oral hypoglycemic agent; ii A1c 7.0; or iii fasting glucose levels 130 mgdl; and iv referred to see a consultant beginning three months prior to the active intervention phase and continuing through enrollment for the last month of the active intervention phase. Patients with either Type l or Type II diabetes will be included. Patients referred will be contacted and asked to participate. 