Background: Within the Bassetlaw Diabetes Clinic population a group of obese patients with poorly controlled diabetes were identified, who appeared to be resistant to standard intervention. An alternative approach, the ‘Sugar Buddies’ programme, was developed, focusing on gradual weight loss and improved glycaemic control. Development of self-care behaviours such as healthy eating, following prescribed testing and medication routines was encouraged. Programme participants attended either individual sessions or a combination of individual sessions and group sessions provided jointly by a diabetes specialist dietitian and diabetes specialist nurse. Aims: To evaluate the effectiveness of the ‘Sugar Buddies’ programme in achieving weight loss and/or improved glycaemic contol in a group of obese patients with poorly controlled diabetes. Method: Measurements of weight and glycosylated haemoglobin (HbA1c)were made at 6, 12 and 18 months on 50 patients participating in the pilot programme. The programme included patients with Type 1 and Type 2 diabetes. All patients had an initial body mass index (BMI) > 30 kg/m2 and HbA1c > 7%. Outcome measures: The proportion of patients who were able to achieve gradual weight loss (a minimum of 2.5 kg over 6 months) and sustain this minimum weight loss over 6, 12 and 18 months. The proportion of patients who were able to achieve a reduction in HbA1c of at least 1% against individual baseline measurements over 6 months, and sustain this reduction over 6, 12 and 18 months. Results: Patients who achieved an initial minimum weight loss of 2.5 kg at 6 months were likely to sustain this weight loss at 12 and 18 months. Patients attending group sessions were more likely to achieve weight loss. Some of the patients who did not achieve weight loss at 6 months but continued in the programme achieved the minimum weight loss goal at 12 and/or 18 months. Patients who achieved a reduction in HbA1c at 6 months were likely to sustain these improvements at 12 and 18 months. Patients attending group sessions were more likely to sustain improvements in HbA1c values. Length of participation in sessions had no impact on HbA1c improvements. At 6 months, three patients (6%) had achieved both a weight loss 2.5 kg and a reduction of at least 1% in HbA1c. Conclusions: The programmes focus on making lifestyle changes achieved a measure of success in weight loss and/or improved glycaemic control among patients previously resistant to intervention.