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The Diabetes Management & PHASE (Preventing Heart Attacks and Strokes Everyday) Management program at the Santa Clara Kaiser Permanente Medical Center is a comprehensive program designed to provide quality care to our patients. Our specially trained Nurses, Pharmacists and Program Assistants partner with our doctors to help members to achieve and maintain proper blood glucose levels, manage cardiovascular risk factors with appropriate medications, and have regular retinopathy screening, foot exams, and physician appointments. We assess the patient’s readiness to learn and make lifestyle changes using motivational interviewing techniques, teach and reinforce self-care skills, and provide clinical management of symptoms according to physicians’ recommendations. Our goal is to monitor and support patients and facilitate treatment so they can lead healthier lives.

What can members expect from the program?

  • Personal care manager communication via telephone, secure emails, video visits
  • Monitoring treatment and progress for Cardiovascular risk (hypertension, statin, A1c, ACE/ARB, ASA, diet and lifestyle)
  • Medication management therapy
  • Information on tools to maintain proper blood glucose via classes, medications or a combination of resources
  • Outreach to members for A1c, Retinal Screening, PCP appointments, PROMPT screenings
  • No fees or co-pays for participation in the program




Eating Healthy