Diabetes Management in Low-Income Hispanic Patients

Inclusion Criteria:

1. Diagnosed with T2DM (documented in the medical chart);
2. HbA1c level > 7.5;
3. Currently treated with diet, oral hypoglycemics or insulin. If currently on insulin, must have a history of prior therapy with diet alone or oral hypoglycemic agents;
4. Hispanic origin;
5. > 18 years old;
6. Telephone in home or easy access to one;
7. Able to understand and participate in the study protocol;
8. Functionally capable of meeting the activity goals;
9. Understands and can provide informed consent (English or Spanish; for illiterate pts we will require that a representative of the pt also understands and signs the consent form on behalf of the pt);
10. Physician approval to participate in the study.

Exclusion Criteria:

1. History of diabetic ketoacidosis
2. Gestational diabetes
3. Unable or unwilling to provide informed consent;
4. Plans to move out of the area within the 12-month study period;
5. Required intermittent glucocorticoid therapy within the past 3 months;
6. Experienced an acute coronary event (myocardial infarction or unstable angina) within the previous 6 mos
7. Has a medical condition that precludes adherence to study dietary recommendations (e.g., Crohn's disease, ulcerative colitis, end-stage renal disease);
8. Has a medical or psychiatric illness (i.e., dementia, psychiatric hospitalization or suicidality within past 5 years or takes an atypical neuroleptic medication). We will not exclude individuals with a diagnosis of depression or pts taking anti-depressants.