This chapter provides a brief overview of diabetes prevalence, the associated complications, diabetes-related mortality and management strategies to set the context for discussing palliative and end-of-life care. This chapter highlights: (1) The increasing global focus on palliative and end-of life-care; (2) The relationship among health trajectories, function and palliative and end-of-life care; (3) The imperative to plan care with the individual to achieve personalised care that meets the individual's goals, preferences, values and spiritual needs across the various health trajectories; (4) The need to proactively plan for the transition to palliative and end-of-life care when appropriate and while the individual can make informed decisions. Proactively planning for changing care needs is more likely to achieve care consistent with the individual's goals, values and preferences; (5) The key role of family carers and the effect of caring on carers' health; (6) The importance of having timely, meaningful conversations about palliative and end-of-life care with people with diabetes and their families; and (7) The imperative to ameliorate suffering, optimise quality of life and personalising care.