Despite medical advances, diabetes management remains a considerable challenge in the United States, with little to no improvement in patient outcomes and stark disparities in underserved communities. One acute challenge is that, as the US population with diabetes grows steadily—numbering 38.4 million people today—there are too few endocrinologists available to treat the disease and the burdens on primary care professionals, who treat more than 90% of cases currently, are staggering. This disconnect between need and care capacity presents what may be the greatest of many threats to the care of diabetic Americans. To understand what is required to solve this need-to-capacity mismatch, we examine the critical role of primary care professionals and propose national policy approaches to empower and improve the nation’s primary care architecture for the nearly 12% of Americans who have diabetes. Policy recommendations encompass the integration of the chronic care model and the patient-cente