The purpose of this study is to test the effectiveness and cost effectiveness of an assisted work process redesign intervention in achieving improved diabetes care in primary care practices. The strategies that we will test represent a novel method for assisting practices in developing the skills to overcome "clinical inertia" and health care system barriers to improved diabetes care by helping them to implement and use a diabetes registry to identify needed clinical or preventive services an opportunities for treatment intensification where appropriate for their patients with diabetes. This is accomplished by helping practices develop methods for improving the efficiency and effectiveness of clinical care processes through integration of a diabetes registry into regular clinical practice. This integration is accomplished through changes in the work processes in the practice setting to ensure that population health tasks (such as outreach to patients who do not attend scheduled chronic care visits and systematic identification for follow up of patients who may not be taking prescribed medication therapies) become a part of the regular work of clinical support staff and other members of the primary care practice team.