Nursing practice changes in outpatient and community settings have focused attention towards the value of registered nurse in improving outcomes and reducing the use of costly inpatient care. The chronic care model is widely accepted as a standard for improving care for people with chronic conditions. Nurses as leaders in chronic care, their role is pivotal in improving care for chronic diseases. Most of patients prefer nurse led shared care for managing diabetes over doctor led care by a ratio of nearly 6 to 1. Chronic disease is an international concern. The increasing incidence of chronic diseases is approaching epidemic levels. Chronic disease as diabetes mellitus is a strain on individuals and on healthcare systems. The Chronic Care Model was developed to improve chronic disease care, but it may also inform delivery of other types of preventive care as long term complications. The Chronic Care Model uses a systematic approach to restructuring medical care to create partnerships between health systems and patients. Diabetes is a major cause of heart disease and stroke among adults around the world. Nurse researchers, such as Wellard, Burckhardt, Baker and Stern, and Lubkin and Larson, were often on the front lines of actual care for patients with ongoing treatments for conditions such as diabetes or renal failure. Finding evidence-based and effective strategies to promote health and to prevent and manage chronic diseases is essential. Others Pioneers have created innovations in Chronic Care model to create the Guided Care model; they combined the principles underlying such innovations and integrated them with primary care. E Health technologies has been especially effective in the management of diabetes.