Objective To improve nursing management level and care quality of diabetes in low-tier hospitals within our diabetes me-dical alliance. Methods We formed a management team for diabetes specialty, and utilized the ORTCC model to instruct nursing management on objectives, rules, training, check and culture in 15 low-tier hospitals within our medical alliance. The effect was evaluated after 2 years. Results The quality of diabetes care, patient knowledge and skills, quality of technical nursing skills and nurses′ diabetes knowledge in 15 low-tier hospitals were significantly enhanced after the intervention (P＜0.01 for all). Conclusion The use of ORTCC model to instruct nursing management in low-tier hospitals within the context of medical alliance, can effectively improve their management level and care quality.