Diabetes mellitus has become a major public health problem in the United States and around the world. A result of genetic predisposition combined with detrimental changes in lifestyle, type 2 diabetes is reaching epidemic proportions. The costs are very high, both in terms of financial burden and quality of life. A wide variety of healthcare organizations have developed diabetes guidelines to improve the quality of care for patients. Increasingly, there is agreement and collaboration on such guidelines, leading to the next step in quality management, performance measures. There is a growing trend to find ways to provide incentives for improved diabetes care. Initiatives such as the National Committee for Quality Assurance's physician recognition program, the Bridges to Excellence Diabetes Care Link program, the National Diabetes Quality Improvement Alliance, and the American Medical Association Physician Consortium for Performance Improvement are all helping to establish an incentive for improved diabetes care.