For many people with diabetes, the hardest part of managing the disease has little to do with medication. Trouble affording food, unstable housing, unreliable transportation, isolation, and the out-of-pocket costs of care all make it harder to keep blood sugar under control. This study tests different combinations of lower-touch and higher-touch support: everyone begins with a low-intensity option that can reach many people at once, and those who need more get person-to-person support added on. Over 12 months, we will follow 594 adults with diabetes to learn which combinations improve blood sugar, who benefits most from which level of support, and what each approach costs, with the goal of a practical model that clinics and health systems can afford to run.
