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Diabetes education is the cornerstone of effective self-care. People with diabetes must understand the physiology of their disease, as well as the interrelated components of self-management in order to achieve optimum control and reduce the risk of acute and chronic complications. Unfortunately, health workers often do not have the time nor the training to provide diabetes education in a format that is accessible to all — including the elderly and those with limited literacy.Poor patient education has contributed to making diabetes the leading cause of death in Mexico. In response, Project HOPE (an international organisation specialising in health education) developed a 24-hour course in a game-based, interactive format for people diagnosed with diabetes and for those at risk. Grounded in the philosophy of empowerment, the ‘5 Steps to Self-Care’ course is imparted over 12 weeks, with weekly homework assignments that reinforce learning as participants share what they learn about diabetes with family and friends. With promising quantitative (A1c) and qualitative (‘well-being’) indicators, the ‘5 Steps’ course has been transferred via a ‘training of trainers’ model to multidisciplinary teams of health workers in 16 primary care clinics and three community groups serving a region of two million inhabitants outside Mexico City. In addition, the project has spurred a grass-roots ‘peer education’ initiative, with course graduates serving as role models and educating others in how to prevent, detect and better manage diabetes at the community level. Copyright © 2006 John Wiley & Sons.