Nowadays, few people would question the role of a person with diabetes as the central figure in his or her diabetes care team. But ‘patient’ empowerment extends well beyond the concept of self-determination. Diabetes does not occur in a vacuum, but interacts with a variety of emotional states and exists within many cultural and social boundaries. People with diabetes hold the power to manage their condition – not their healthcare providers or their family members. In this article, Michael Weiss argues that people can only make the many finely balanced management decisions that are required throughout each day based upon informed involvement in the development and implementation of a workable diabetes self-management plan.