From 2006, the Annali AMD publish annually the profiles of people with type 1 diabetes and type 2 diabetes followed by Italian diabetes services. The Annali AMD are a case model for quality improvement activities in chronic diseases and a tool to evaluate the level of adoption/acceptance of guidelines in clinical practice. The considerable success documented, was obtained without allocation of financial incentives but simply through a physician-led effort made possible by the commitment of the Italian specialists involved.