Journal of Primary Care & Community Health 1(1) 55 –61 © The Author(s) 2010 Reprints and permission:

Chronic hyperglycemia in persons with diabetes is associ-ated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.1-4 Despite this evidence and advances in literature related to known modifiable risk factors for diabe-tes, diabetes-related complications, and effective interven-tion strategies, the disease epidemic continues to burgeon.5-7 To date, more than 23.6 million people (>8.0 % of the US population) in the United States have diabetes, and 23.5 million of them are adults 20 years and older.8,9 A recent study estimates that the prevalence of diabetes will more than double between 2005 and 2050.10 This is due to several factors that include unhealthy lifestyle (eg, unhealthy diets and inadequate physical activity), the obesity epidemic, and demographic changes (eg, aging and increased growth o