This paper uses 85 semistructured 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.