Dissertation (MSc Nursing Education)In Tanzania the available data shows that diabetic patients are in risk of developing different life-threatening health complications, this lead to increased medical expenses, reduced quality of life and increased mortality rate. Different innovative teaching methods are needed in order to prevent and to control the burden of diabetes. Thus, the current study was aimed to assess the efficacy of peer support learning strategy on improving competence and health outcomes among adult diabetic patients attending clinic in Dodoma region. A quantitative approach with controlled quasi-experimental pre-post design was used. A total of 72 intervention and 72 control were selected randomly. Interviewer administered questionnaires was used in addition glucose level and blood pressure also was checked at pretest and posttest. Six expert patients were trained and conducted two face to face meeting to their fellow patients for sixty minutes each meeting within one month. Data was analyzed by using Statistical Package for Social Sciences software number 26.0, both descriptive and inferential statistics was used. The mean age for study participants was 54.86 in control group and 53.33 in the intervention group. The independent t-test showed significant difference between groups for competence; the mean scores in the post test for knowledge was (M=0.194) for intervention group and (M=-0.203) for control group, p-value <0.005 with the medium effect size of 0.3. The results for attitude at postest was (M=0.463) for intervention group and (M= -0.485) in the control group, p-value <0.005with the large effect size of 0.9. Self-care practice at posttest was (M=0.467) for intervention group and (M= -0.489) for control group, p-value <0.005 with large effect size of 1.0. For adherence at posttest (M=0.601) for intervention and (M= -0.630) for control group, p-value <0.005 with large effect size of 1.0. Multiple linear regression was done and does not found any confounding factors that lead to change in all competence rather than intervention. For health outcomes the independent t-test showed no significant difference between groups, mean score for Fasting Blood Glucose at post was (M=8.225) for intervention and (M=8.987) for control, p-value >0.005. Random Blood Glucose at posttest was (M=14.088) for intervention and (M=-13.682) for control group, there was no significant difference between two groups, p-value >0.05. For Systolic Blood Pressure at posttest (M=141.71) for intervention and (M=140.39) for control. At posttest Diastolic Blood Pressure was (M=78.71) for intervention and (M=78.69) for control group, p-value >0.005. Multiple linear regression was done showed that, the age had effect on SBP change with stimate (β) of 0.339, p-value <0.005 and DBP change by estimate (β) of 0.44, p-value >0.005. Finding indicate peer support learning strategy can be attained and used in area with human resource constrain like Tanzania. Further study should be done in order to reach large population of Tanzania. Key words: Peer Support Learning Strategy, Competence, Health Outcomes, Diabetes, Dodoma, Tanzania.