More than a decade of investment, integration and innovation in primary and community diabetes care in Ealing, UK, is now showing tangible and sustainable improvements in metrics of good diabetes care. From a low baseline, data from the National Diabetes Audit show improvements in both the care processes delivered and, crucially, the biomedical outcomes achieved in the Three Treatment Targets -for both type 1 and type 2 diabetes. This was accomplished while the prevalence of diabetes increased from 6.4% to 9%. Analysis of hospital admissions data suggests that a number of diabetes-related admissions reduced with possible associated cost savings of greater than £400,000. Factors contributing to these improvements are discussed. Ealing is therefore an exemplar case study for improving diabetes care services within the future Integrated Care Systems.