This investigation examined the impact of social support messages on patient health outcomes. Forty-one American Indian, Alaska Native, and Native Hawaiian patients received a total of 618 e-mail messages from their healthcare provider (HCP). The e-mail messages were divided into 3,565 message units and coded for instances of emotional social support. Patient glycosulated hemoglobin scores (HbA1c) showed significantly improved glycemic control and emotional social support messages were associated with significant decreases in HbA1c values. Patient involvement with the system, measured by system login frequency and the frequency of uploaded blood glucose scores to the HCP, did not predict change in HbA1c. (Contains 2 tables and 1 figure.)