The CDC recently published a report on the underutilization of diabetes self-management education and training (DSMT) among privately insured individuals with newly diagnosed diabetes from 2011-2012 in the US. The analysis, which collected insurance claims data from the MarketScan Commercial Claims and Encounters database, found that out of 95,555 newly diagnosed adults, only 6.8% participated in DSMT during the first year after diagnosis of diabetes. As background, the DSMT curriculum includes information about the disease process and treatment options as well as guidance on healthy lifestyle, blood glucose monitoring, and other topics. The ADA recommends providing DSMT to patients soon after diagnosis, as they are typically most receptive during this early time period. Therefore, these findings point to a disturbingly large gap between guidelines and actual practice, even within the insured population. With such low utilization rates in privately insured patients, we are not optimistic about the use and access in other patient populations. As we see DSMT participation as a critical first step in helping patients manage their disease, this research stresses the urgent need to address health system barriers such as inadequate reimbursement for DSMT (see our coverage from this past AADE for more on this issue) and patient-level factors including lack of awareness about DSMT and personal perceptions about diabetes so that the field can better provide patients with the tools to begin treatment early.