• A1c [ Time Frame: 6 months and 1 year ]
  

• diabetes-related self-care behaviours, drug use, clinical outcomes [ Time Frame: 6 months and 1 year ]
  
• diabetes-specific quality of life [ Time Frame: 1 year ]
  
• incremental cost/quality-adjusted life-year [QALY] [ Time Frame: 6 months and 1 year ]
  

Diabetes mellitus (DM) is a common chronic disease that is rapidly rising in prevalence, affecting upwards of 35,000 adults in the Hamilton, Ontario region (population 400,000). The magnitude and growth of the problem and its serious health consequences suggest that:

1. diabetes is now a major public health problem; and
2. interventions at the community level are needed to mitigate its health impact.

During the last 5 years, Diabetes Hamilton was successfully piloted as a free community-based program available to anyone with diabetes. It promotes diabetes self-management, self-efficacy and awareness through the provision of generalized diabetes information (e.g. newsletters, workshops, forums, resource directories) to consumers, local physicians and other health professionals.

This trial will determine if supplementing Diabetes Hamilton with an automated tailored feedback system that:

1. provides information;
2. generates and communicates specific evidence-based recommendations to users from a self-administered questionnaire;
3. copies this communication to the patient's designated physician;
4. facilitates access to community resources; and
5. provides a simple way for the patient to track changes in indicators of health can improve A1c and other diabetes care indicators more than Diabetes Hamilton alone.