Background: More than 10% of Americans have diabetes, with higher rates in Hispanics and African Americans. National Healthy People 2030 goals for expected decrease in HbA 1c levels have not been met. Local Problem: No standardized diabetes education or follow-up existed at a free clinic. Patients exhibited diabetic self-management inadequacies and elevated HbA 1c levels. Methods: A pre/postimplementation study design was used to evaluate changes in HbA 1c levels, medication adherence, missed appointments, and emergency department visits. Interventions: Structured diabetes education and follow-up text/phone messages for patients with HbA 1c levels 8% or higher were implemented over 3 months. Results: Outcome data were available for 27 of the 34 participants. Postimplementation, there was a significant 1.7% decrease in mean HbA 1c levels (P < .001). No significant differences were found for the other outcome measures. Conclusions: Structured diabetes education and follow-up text/phone messages in a free clinic improved patients' HbA 1c levels.