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.