OBJECTIVES:  The study aimed to evaluate pharmacist’s educational and counseling impact including adherence to instructions of diabetic patients’ outcomes in the endocrinology clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria METHODS:  This was a 6 Month randomized controlled study involving 150 consented elderly type 2 diabetic patients. Patients who met the inclusion criteria were randomly assigned into both control and intervention groups (75 patients each). The 75 patients on our intervention group were educated by the Pharmacist on diabetes and hypertension, their complications, risks, preventive measures and management. This was done at least six times during the study period unlike the control group who received no such education. In particular, they were counseled on the need for medication and treatment adherence such as clinic visits, and life style modifications including diet and exercise. Outcome measure included changes in fasting blood sugar (FBS), blood pressure (BP), body mass index (BMI) and adherence to instructions. RESULTS:  There were no statistical differences between the baseline and 6 months data of the control group as mean fasting blood sugar were 162.2 ± 69.1 and 159.9 ±57.2 (P= 0.825) and mean systolic blood pressure of 144.7 ± 23.8 and 145.5±18.6 (P= 0.819) respectively. The intervention group had mean fasting blood sugar of 156.7 ± 30.5 and 131.8± 40.4 (P< 0.001) and mean systolic blood pressure of 146.4 ± 13.9 and 133.8 ± 18.5 (P< 0.001) respectively. Adherence levels to medication taking in the groups were 42.7% : 94.7% respectively (P=0.001). CONCLUSIONS:  In diabetes management, patient education and counseling have become key tools in achieving both glycaemic and blood pressure control.