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Background:The purpose of this study will be to improve diabetes prevention, access to care andadvocacy through a novel cost-effective nurse-led continuum of care approach that incorporatesdiabetes prevention, awareness, screening and management for low-income settings, andfurthermore utilizes the endeavor to advocate for establishing standard diabetes program in Nepal.Methods:We will conduct a two-arm, open-masked stratified cluster randomized controlled trialof a NUrse-led COntinuum of care for people with Diabetes (N 1 =200) and pre-diabetes (N2=1036)(NUCOD), with primary care centers (9 Outreach Centers and 17 Government Health Posts) as aunit of randomization.NUCOD will be delivered through the trained diabetes nurses in thecommunity to the intervention group and the outcomes will be compared to the enhanced usual-treatment group at 6 and 12 months of the intervention.The primary outcome will be change in.