Type-1 diabetes results from cessation of endogenous insulin production. Self-management is essential for patients with type-1 diabetes to prevent secondary organ damage and premature death. Self-management may be inhibited by a vast array of psychosocial factors, and therapy is unlikely to be successful unless these factors are identified and addressed. A pilot study of seven patients from Norfolk in the United Kingdom was undertaken to investigate the psychosocial factors interfering with diabetes self-management. Occupational therapy assessments and interventions were provided in an outpatient clinic. Patients' capacities for diabetes self-management were adversely affected by physical and psychological comorbidities, financial hardship and family responsibilities. Health problems resulting from sub-optimal diabetes self-management included visual impairment, lower limb amputation, erectile dysfunction, hypoglycaemia and diabetic ketoacidosis. A combination of these problems impacted on patients' spiritual lives, interpersonal and intimate relationships, employment prospects, finances and personal power, pleasure and security.