Following a national trend, rural areas have, since 2010, experienced an increase in both the prevalence and incidence rates of diabetes. This increase in diagnosed diabetes means the Healthy People 2010 goal of reducing the prevalence rate and new case rate has not been met, especially in rural areas. The proportion of people who have been diagnosed with diabetes is improving, but the proportion of persons with diabetes receiving preventive screenings, though improving, has not met the Healthy People 2010 goals. While the rate of diabetes-related deaths has slowly decreased, and rates of diabetesrelated complications such as end stage renal disease and non-traumatic lower-limb amputation have decreased over the last decade, they are still high in rural areas. Access to diabetes education is increasing with the introduction of telemedicine technology, but still lags behind the Healthy People 2010 goal of 60 percent of persons with diabetes receiving diabetes education. Telemedicine and computerized support for diabetes prevention and management is more difficult in rural areas.