The Confederated Tribes of Grand Ronde has provided diabetes prevention and care services for approximately 24 years and seeks to continue SPDI programming for our patients and community. For this five-year project, we plan to ensure adequate access to diabetes care and prevention services through case management, regular scheduled A1c testing for diabetic screening and tracking, implement cooking demonstrations to allow diabetic and pre-diabetic patient to take control over their nutritional needs, and incorporate diabetic education and trainings to our staff, patients, and the community. Additionally we plan to provide diabetic foot care for patients, quarterly educational presentations and materials distributions to the community, establish a walking and fitness group for diabetic patients to enhance physical fitness and health.