We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Care coordinators monitored the answers from the devices daily so that early interventions could be made. There were significantly more deaths in the control group (n = 102, 26%) compared with the intervention group (n = 75, 19%). There was longer survival for the intervention group versus the control group (mean survival time 1348 vs 1278 days; P = 0.015). A multivariate analyses indicated that the telemonitoring programme was associated with reduced 4-year all-cause mortality (hazard ratio = 0.7, 95% CI 0.5-0.9, P = 0.013). The results suggest that daily management of patients with diabetes through home monitoring by a registered nurse reduces mortality.