Since joining the Diabetes Collaborative in 1999, we have launched a series of quality improvement projects in the area of diabetes care. These include tracking clinical outcomes, quarterly reports to primary providers about their patients' diabetic outcomes, and improved diabetes education activities. In addition we have improved collaboration among a variety of disciplines (medicine, dentistry, optometry, health education, and nutrition) to actively participate in systems improvements for diabetes care. As a result of these activities, we have shown a decline in blood sugar in diabetic patients. Building on the success of La Clínica's diabetes collaborative work, in 2002 The Bureau asked the clinic to participate in their pilot Diabetes Prevention Collaborative (which seeks to replicate the results of the successful Diabetes Prevention Program published in 2001.) Through this program we have identified over 400 patients with "pre-diabetes", and have entered them into an intensive lifestyle inter vention focused on diet and exercise change. In 2002 La Clínica also launched another diabetes initiative, the Advancing Diabetes Self-Management Program, funded by the Robert Wood Johnson Foundation. This program uses Health Promoters (or "Lay Health Advisors") to help diabetic patients with poor blood sugar control to improve their self-management techniques. So far, over 200 patients are working with health promotors with demonstrated improvements in blood sugar control.