The specific aims of this study are to test whether in a cohort of low-income minority veterans with poor diabetes mellitus (DM) control:

1. Peer counseling is an effective means of reducing HbA1c (a measure of glucose control).
2. Financial incentives are an effective means of reducing HbA1c. This is a randomized controlled pilot study. There will be 3 arms: 1) a control group of poorly controlled diabetics getting usual care; 2) peer counseling with no incentives; and 3) financial incentives without peers. Ultimately, contingent on the success of this intervention, the researchers plan to apply for funding for a large scale intervention employing both peer counseling and incentives to improve DM control in low income and minority patients who are at high risk for premature morbidity and mortality.

Inclusion Criteria:

• African American veteran
• 50-70 years old
• ICD-9CM diagnosis code consistent with DM (any ICD-9CM code starting with 250)
• For patients: last two HbA1c greater than 8% with at least one measure being within 3 months of enrollment
• For peer counselors: HbA1c of greater than 8% in the past 3 years and an HbA1c less than or equal to 7.5% within 3 months of enrollment

Exclusion Criteria:

• Unstable medical condition that would likely prevent the subject from completing the study
• Patients enrolled in Telehealth will be excluded as such enrollment does not constitute usual care