This program helps UCSF primary care adult patients with type 2 diabetes who have a blood sugar level (A1c) of 8% or higher. Our Diabetes Collaborative Care team, led by nurses and a healthcare navigator, will work with you, your primary care team, and endocrine consultants to improve your health. We will give you advice on how to eat better, exercise, and manage your medications.
How the program works
Getting Started with the Diabetes Collaborative Care Program
- A healthcare navigator will call you or send you a message on MyChart to tell you about the program.
- The healthcare navigator will ask you questions about your health during the first phone call or set up another time to talk that works for you.
- You’ll also talk to a nurse about your health goals, medications, diet, exercise, and other topics that help you manage your diabetes.
Ongoing care with the Diabetes Collaborative Care Program
- The nurse will share your information with the program’s endocrine consultants. Together, they’ll work with your primary care provider to provide recommendations about your medications, labs, and healthy lifestyle choices.
- You will meet one-on-one with the nurse or healthcare navigator by phone or video calls to help you reach your health goals and connect you with more services.
- For the first three months, you will meet with the nurse about once every one to two weeks. As you get closer to your goals, you’ll meet with the healthcare navigator about once a month until you finish the program.
- You might need to check your blood sugar or get lab tests done regularly so that the team can make the best plan for your diabetes care.
Completing the program
- You will finish the program after one year. At the end of the program, you should see your A1C improve and feel better about managing your diabetes.
