Inclusion criteria Adults 18 years and older with confirmed T2D (as diagnosed by physicians and based on the history of medicines they have been taking) Exclusion criteria Patients with diabetes type 1, gestational diabetes, pregnant women and people with severe cognitive impairment or terminally ill people Intervention Training handbook For a phased and an intensified DSME, an Ethiopian context patient friendly handbook with illustrative pictures has been prepared. To help illiterate/less-literate patients the DSME materials are mainly supported by illustrative pictures with short text explanations. The content includes: basics of diabetes, healthy eating, healthy exercise, medication management, prevention of acute and long-term complications, foot care and psychosocial issues in diabetes.