1.Lack of knowledge and understanding of a specific diet plan
2.Lack of individualized and coordinated care
3.Helplessness and frustration from lack of glycaemic control despite adherence
4.Limited resources to obtain recommended equipment,medicines,laboratory tests and provider services
5.Inconvenient,costly and non-specific group education sessions
6.Difficulty in remembering to take of knowledge about medication action,side effects,schedules and adjustments