Preliminary Data As above, AMPATH's CDM Program has an extensive network of rural health facilities delivering care for diabetes and hypertension. Although there have been notable improvements in clinical measures, nearly 60% do not link to care and nearly 50% do not remain in care once enrolled. Women are twice as likely to engage in care as men. The CDM Program has piloted various forms of group care for diabetes and CVD risk factors and has determined that group care is feasible and acceptable in this setting. The program implemented diabetes self-management support groups providing community-based peer support as a supplement to health facility-based clinical care, education, and counseling. These groups included a peer leader with specific training, and they had regularly scheduled meetings during which members learned about behavioral modification, self-management strategies, and problem-solving approaches. Analysis of 148 subjects at three months revealed that 76% of members attended group meetings at least once per month. Median hemoglobin A1C improved from 9.6% to 9.1%, but there were no significant changes in BP, body-mass index, or waist circumference.