OBJECTIVE: To compare the impact of a diabetes disease management program (DDMP). METHODS: A pre/post comparison was conducted to evaluate a DDMP program in a V.A. nursing home. All diabetic patients residing as of September 1998 (pre-DDMP) were compared with those residing there in November 1999 (post-DDMP). Data collection included age, sex, types of diet, functional categories, weight, body mass index (BMI), cholesterol, hemoglobin A1C (HA1C), urinalysis, eye and foot exams, and antidiabetic drug therapies. RESULTS: The pre-DDMP group had 31 males, mean age 76 years; post-DDMP group had 36 males, mean age 77 years. Eighteen men of the 36 men were in both the pre and post-DDMP groups; the remaining post-DDMP group was admitted between study periods. Post-DDMP group had a higher average BMI (p<0.01) and functional category (p<.04); attributed to the men admitted after starting the DDMP. Number of patients achieving HA1C semi-annual testing criteria was statistically greater in the post-DDMP sample (30 pts (83%) vs. 13 pts (42%), p<.001). Mean HA1C results were better in the post-DDMP sample (6.8% vs. 8.2%, p<.01). Post patients were more likely to have foot exams (p<.001). Changes in rates for urinalysis, cholesterol, and eye exam were not statistically significant. Twelve pre-DDMP patients were managed by diet alone; eleven in the post group. More post patients were managed by two or more drugs (p<.04) which was attributed to men admitted after starting the DDMP. CONCLUSION: Post-DDMP group had more HAIC testing and better average results. A major observed change was in the increase usage of drug combinations which might be reflected in the observed improvement of glycemic control.