Using an inductive interpretive approach we examined the early experiences of women learning intensive self-management of type 2 diabetes. The women expressed feelings of being very much "home alone" during their initial self-management experience, in spite of having requisite knowledge and skills from completing a state-of-the-art multidisciplinary diabetes educational program. Invariably, engagement in the self-management process resulted in strong emotional responses, self-blame, and negative characterizations of self. Conditions associated with ways of being engaged in intensive self-management are described and provide practitioners with needed personal and contextual information to inform clinical care.