Abstract: Background: Appropriate interpretation of health information by the patients with type II diabetes mellitus is crucial for the improvement of their management. Purpose: To examine the effect of nursing-led health literacy sessions on patients' health literacy, self-care practices, and distress among those with type II diabetes mellitus. Setting: The study was conducted at the Menoufia University Hospital's Outpatient Clinic for Diabetes Mellitus and Endocrines in Shebin El-Kom, Menoufia Governorate, Egypt. Instruments: Five instruments were used, bio-socio-demographic structured interviewing questionnaire, diabetes knowledge test, diabetes specific health literacy scale, summary of diabetic self-care practices questionnaire as well as diabetic distress scale. Results: Showed statistically significant improvements in the mean scores of patients' knowledge, health literacy, self-care behaviors and diabetic distress in favor of the posttest after health literacy sessions where the means ± SD and p values in the posttest were (17.07±4.4, P=0.000; 57.19±13.6, P=0.000; 48.14±12.09, P= 0.000, and 1.75±0.63, P=0.000, respectively). Moreover, the results of Pearson's correlation coefficient showed a positive correlation between health literacy and patients' knowledge (P=0.000, r=0. 62), as well as health literacy and self-care practices (P=0.001, r=0. 32). There was also a positive correlation between health literacy and age (p=0,001, r= .82). Additionally, presence of negative correlation between health literacy and distress (P=0.000, r=0. 65). Conclusion: Diabetes self-care education sessions led by nurses can enhance knowledge and practice among diabetic outpatients and reduce diabetic distress. According to the study, hospitals should routinely offer patients health literacy education and training on managing their disease. Recommendations: Since self-care practices and distress levels in diabetic patients can be affected by health literacy, nurses are advised to create and implement straightforward educational interventions to improve health literacy, which will in turn encourage self-care practices and reduce distress.