Shared Health Appointments and Reciprocal Enhanced Support

Inclusion Criteria:

Veterans enrolled into diabetes Shared Medical Appointments (SMAs) at participating sites, and a random subset of those meeting criteria for diabetes SMAs who have not yet participated:

* Veteran receiving care at a participating VA Medical Center
* Meets at least one of the following criteria in the past 2 years;

* at least 1 VA hospitalization with a diabetes-related International Classification Of Diseases-9 (ICD-9) code,
* at least 2 VA outpatient visits with a diabetes-related ICD-9 code, or
* At least 1 VA prescription for a glucose control medication (insulin or oral agent) or monitoring supplies
* Poor glycemic control, indicated by a HbA1c in the past 6 months or:

* at least 7.5% if age \<70, or
* at least 8% if age 70+
* Has a current address and telephone number listed in VA databases
* Is competent to provide informed consent
* Can communicate in English and by telephone
* Able to participate in an outpatient program

Exclusion Criteria:

For no intervention control group:

* Active substance abuse disorder (smoking cigarettes is not an exclusion)
* Serious psychiatric illness (bipolar disorder, dementia, schizophrenia, or personality disorders)
* Terminally ill
* Prisoner