The purpose of this study is to determine if tailored letters sent to diabetic patients will improve care of diabetes.

Diabetes care in the US is less than optimal. Some authors have found that targeted patient letters are also an effective tool to improve outcomes when they are part of a comprehensive disease management plan. Local patient satisfaction surveys had revealed that many patients had sub-optimal understanding of diabetes measures and of the importance of controlling these measures to reduce diabetic complications. We wondered if tailored patient letters and enclosed lab orders when due might increase patient awareness of diabetes measures and increase patient engagement.We hypothesized that the addition of targeted patient letters with enclosed lab orders to an ongoing performance improvement program would further improve diabetes care.

We conducted a randomized controlled study of tailored patient letters and diabetes lab orders at our two resident-based clinics.

Inclusion Criteria:

• All active patients age 18 to 75 years with a diagnosis of diabetes mellitus were eligible.
• An active patient was defined as one having an ICD-9 code on the active problem list identifying the patient as diabetic, and a progress note in the EMR associated with an office visit within the prior 12 months.

Exclusion Criteria:

• None