More than 23.6 million people have diabetes in the United States, and pre-diabetes is far more common than previously believed. About 26 percent of U.S. adults aged 20 years or older, or 57 million people, currently have pre-diabetes. Racial and ethnic minority groups, especially the elderly among these populations, are disproportionately affected by diabetes. Through a wide array of community health centers and outreach initiatives, safety net health systems are leading the charge in providing diabetes care management—keeping people healthy, out of the hospital and reducing unnecessary complications.