Diabetes mellitus has considerable and increasing importance in England. The burden of illness is concentrated in ethnic minority groups and socioeconomically deprived areas. Evidence for effective clinical care has increased following the results of the UK Prospective Diabetes Study but current diabetes care services are variable in quality. These inequalities and inequities are being actively addressed through current national policies to improve access and quality of care through agreed national standards. These standards encourage a shift towards a patient-centered, primary-care led service working closely with multidisciplinary diabetes specialists.