Patient education is an essential component in the treatment of diabetes mellitus. Understanding the difficulties encountered during patient education helps health providers to offer better education programs and therefore to achieve better disease outcomes. We performed two questionnaire-studies in the year of 2003 and 2004 to evaluate the difficulties encountered in diabetes education. In addition, we try to find out the impacts of ”Global Budget Payment System” and ”Diabetic Case Management” on diabetes education. Our results found institute and administrative factors, especially short of education manpower, were the major problem resulting in education difficulties. ”Global Budget Payment System” and ”Diabetic Case Management” add some difficulties on diabetes education. Our study found the administrative institutes must provide more support to solve the difficulties encountered in diabetes education.