Central Valley Indian Health Diabetes Treatment and Prevention Program is comprised of a multi-disciplinary team consisting of physicians, registered dietitians (CDCESs), outreach registered nurses, community health representatives as well as other allied health professionals. The team coordinates patient care with the objective of addressing health issues related to diabetes in the Native community. Comprehensive patient care is delivered to patients in a variety of ways, including medical, dental, behavioral health, podiatry, optician, nutritional as well as other clinical services. Home-bound patients living in outlying service areas within Fresno, Kings and Madera counties are eligible for blood pressure and glucose checks, performed by public health registered nurses and CHRs. Additionally, transportation to clinical appointments and medication pick-up and delivery are also available as another way to facilitate patient self-management of diabetes. The CVIH website provides resources, including tobacco cessation, summer lunch programs for school-aged kids, other food insecurity resources as well as links for classes on prevention of diabetes, just to name a few. Patients are encouraged to utilize clinic-issued glucometers so blood glucose readings may be downloaded at clinic visits and printed in graph and chart formats for physicians, other clinic staff and patients to review. Utilizing this data is useful for optimizing patient-centered care so that glycemic control may be achieved for the prevention of diabetes-related complications. Literature from Indian Health Service such as "A River Runs Through Us", "My Native Plate," the "Eagle Series" as wells as many other IHS curricula are utilized to support the Best Practice of Nutrition Education.