This paper uses 85 semi-structured interviews with people with type 2 diabetes, and with the health professionals who deliver their diabetes care, to explore the issues that they perceive as central to effective management of diabetes primarily within a primary care setting. Attention is especially focused on the nature of the patient-practitioner relationship, and on the implications of this for patient empowerment and the effective self-management of diabetes. The paper is organized around five key concepts identified in the qualitative analysis: the importance of having sufficient time for consultations; the significance of continuity of care through a named individual; the need for patients to have an opportunity to ask questions during a consultation; the extent to which patients feel that they are listened to by health professionals; and the variability of each patient�s individual experience of living with diabetes. In conclusion, these themes are briefly related to key issues in the geography of health.