**Acknowledgements**

First and foremost, praise be to Almighty Allah for the countless gifts I have been offered and for helping me and giving me the power to pass safely through all difficulties and overcome them. I would like to express my deepest gratitude to Prof. Salwa Abbas Ali Hassan, Professor of Community Health Nursing, Faculty of Nursing, Zagazig University for her instructive supervision, guidance and continuous encouragement to produce this work. I am indebted to her valuable consultation and direction. My deepest gratitude and sincerest appreciation are also extended to Prof. Dr. Hassan Ali Abdelwahid, Professor of Family Medicine, Faculty of Medicine, Suez Canal University for his instructive supervision, guidance and continuous encouragement to produce this work. I am indebted to his valuable guidance and advice. My deepest gratitude and thanks are also extended to Dr. Hanaa Kassem Farg, lecture of Family and Community Health Nursing, Faculty of Nursing, Suez Canal University for her instructive supervision, guidance and continuous encouragement to produce this work. I am indebted to her valuable consultation and direction. Special thanks to every diabetic patient who participated in the conduction of this study. Finally, I would also like to extend my deepest gratitude to all the team members of Family Medicine Outpatient Clinic and Endocrine Outpatient Clinic at Suez Canal university Hospitals and to all those who helped me to fulfill this study.
