More than 16 million Americans have diabetes. It is the sixth leading cause of death by disease in the USA. The American Diabetes Association’s Provider Recognition Programme, launched in 1997 to encourage and set standards for comprehensive and quality healthcare for people with diabetes, is working. Minneapolis has created such a model which has achieved ADA recognition. The result has been a significant improvement in blood glucose control among the HMOs’ patients, as well as better screening for – and control of – related risk factors for cardiovascular disease.