A workshop was convened to examine factors determining patient self-management and implications for those providing care. It was attended by 15 doctors and 15 nurses with considerable expertise in education for those with diabetes. Discussion included: the experience of training programmes to date; factors determining effective patient self-management; the implications for training of professionals, skills required, their current availability and proposals for their development. The conclusions were that training and experience of these skills are both inadequate. Programmes of training, which are equally applicable to the management of other chronic diseases, should be embedded in the system of care and delivered at local level. Regional or national programmes are required to develop trainers in all districts able to deliver and maintain local programmes. This critical element of care in diabetes must be adequately funded if self-care standards are to be improved and expensive complications prevented.