We piloted a culturally sensitive diabetes case management tool (CDMP) in an urban community health center, integrating clinical algorithms, decision support, and telemedicine eye screening. The study randomized 40 Hispanic patients with Type 2 diabetes to case management intervention (CMI) or attention control (AC). CMI patients received 6 individual visits with a Hispanic diabetes nurse and dietitian over one year. Six-month findings revealed significant improvements: HbA1c decreased more in CMI (-1.2%±1.4) compared to AC (-0.07%±1.0, p<0.02), and blood pressure significantly lowered. Eye screening showed 26.3% of CMI patients needed retinopathy follow-up. Diabetes Self Care Profile (DSCP) results highlighted psychosocial challenges: 87.5% reported barriers, with 66.6% experiencing high emotional distress, 52.3% major depression, and 57.1% hypoglycemia. PAID scores significantly improved for CMI (-11.8± 24.8) versus AC (+4.4 ±21.2, p<0.03). The pilot demonstrated improved clinical and psychosocial outcomes, effectively identifying patients requiring treatment and managing diabetes-related challenges.