Diet and exercise are the cornerstones of treatment for persons with type 2 diabetes mellitus, yet patients find these areas of self-management to be the most difficult. Considerable research has indicated that barriers to diet and exercise are critical influences determining adherence to diet and exercise plans. Standards of practice require educators to assess patient barriers to self-management. However, little research has investigated whether patients and educators perceive these barriers similarly. This project's objectives were to compare and contrast patients' and educators' perspectives of patient barriers to following a meal or exercise plan, and to identify differences in patients' perceived barriers as related to patient characteristics. Patients with type 2 diabetes mellitus (n = 97) from three eastern Washington area hospitals and diabetes educators (n = 143) from the Washington Association of Diabetes Educators (WADE) were recruited for a mail survey. From the patient survey, the proportion of patients on meal plan (52%) or exercise plan (26%) was low. Certain barriers were prominent for both patients and educators relative to diet (difficulty maintaining a diet away from home, liking foods not in the meal plan) and exercise (not a high priority, weather). However, multivariate analyses indicated that patients and educators view barriers differently. Similarities and differences between educators and patients in response to barriers are discussed relative to enhancing diabetes counseling and education, and overall communication between educators and patients.