This paper documents the development of an outcome framework for the Diabetes Literacy project. After an initial systematic metaliterature search, it was concluded that existing studies could not provide the necessary information to consistently answer the question if some interventions are more effective than others. Studies use a plethora of psychological-, social-, behavioral-, clinical- and wellbeing-outcomes. This reveals not only the field´s complexity but also the different perspectives on what may or may not be regarded as desirable outcomes of DSM interventions. In order to deal with the different kinds of outcomes, the research team of the Ludwig Boltzmann Institute Health Promotion Research initiated an in-depth investigation of outcomes, resulting in the development of a DSM outcome framework (DSMOF) for the Diabetes Literacy project.