The purpose of this pilot study was to test the effectiveness of an in-home, nurse-delivered, symptom-focused teaching/counseling intervention with older rural African American women who have type 2 diabetes. Forty-one participants were randomly assigned to either the intervention or the comparison group. Participants in the intervention showed statistically significant improvement in their medication, diet, home glucose monitoring self-care practices, perceptions of quality of life, and distress from symptoms. Both groups evidenced improvement of HbA(1c) levels. The intervention group achieved greater improvement, but the difference was not statistically significant. Participant satisfaction was high. Further studies should look into the cost of the intervention, as compared with that of usual care, and its long-term effects.