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Advanced Comprehensive Diabetes Care (ACDC)

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ACDC is a nurse-administered telehealth intervention for Veterans with poor diabetes control despite standard VA diabetes care. ACDC augments standard VA Home Telehealth services with diabetes self-management support and clinician-guided medication management. Critically, ACDC is specifically designed to use only existing VA staffing and infrastructure, so can be easily implemented in practice. In a randomized trial, ACDC improved hemoglobin A1c by an average of 1% vs. usual care, and by ~2% among engaged Veterans. ACDC’s real-world effectiveness has been confirmed at multiple VA sites. Rigorous qualitative testing shows that ACDC is well-liked and greatly appreciated by Veterans and participating staff.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.


December 2013, Durham VA Medical Center


3 successful, 7 in-progress, 1 unsuccessful

Awards and Recognition:

Diffusion of Excellence Promising Practice, Rural Promising Practice, VHA Shark Tank Winner



  • Mean hemoglobin A1c reduction 1.4% (n=230)
  • Qualitative Veteran and staff feedback is consistently positive
  • Implementation is cost-neutral in the short-term, and is likely to be cost-saving as the benefits of diabetes control accrue

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)





During the 2018 Shark Tank competition, the VA Diffusion of Excellence Initiative selected ACDC as a winner, or Gold Status Practice.