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The New Brunswick Diabetes Strategy was endorsed in June 2011. This 4-year strategy is based on the chronic care framework and integrates a wide array of actions within the health and community sector with the goal of improving "everyday pathways" for patients and providers. The strategy encompasses a variety of actions to target improved levels of A1C, LDL, blood pressure and foot care. A diabetes registry was created allowing fee for service primary care providers to receive a personalized profile of all the patients with diabetes in their practice and each patients latest A1C and LDL result as well as cumulative data on the average A1C and LDL in their patient population compared to those of their peers in the same geographical zone. Providers also receive a bright "pink sheet" in their lab reports anytime a patient has an A1C >7%, which lists the cumulative 5-year A1C's for that individual. Diabetes case managers have been hired to rotate through family practices to focus on patients with A1C's >8% and community health coaches work with patients on goal setting and follow through. Facilitation of provincewide implementation of hospital insulin order sets has been initiated to optimize inpatient diabetes care. A clinical innovation fund provides seed money to deserving hospital and community projects. Key features of this strategy include the affordability and sustainability of action areas with the goal of effective system change.