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The roles of the diabetes educator (DE) have expanded significantly from the basic instruction on self-care on which the profession was established and now encompass a range of key responsibilities within diabetes care. A major focus of recent literature has been evaluation of the effectiveness of diabetes self-management education for such factors as reducing the incidence of diabetes, improving clinical parameters and improving medication adherence. This review describes how DEs and diabetes educational services have impacted patient health, how the role of the DE has changed in the past decade and what roles these professionals may serve in the evolving paradigm of primary care for patients with diabetes. Looking forward, the integration of DEs into coordinated care teams will likely increase to meet the challenges associated with providing quality care to a rapidly expanding population with type 2 diabetes.