This review presents findings from a critical integrative review of research into barriers to and facilitators of self-care from the perspective of people with diabetes. The review was motivated by a perceived need to understand self-care from the perspective of those living with this chronic disease and to explore the implications of this understanding for health-care policy in Canada. Journal manuscripts and dissertations exploring self-care from the perspective of adults with type I or type II diabetes and published in English between 1993 and 2003 were reviewed. Both quantitative and qualitative studies were included. Studies were informed by varying definitions of self-care and facilitators and barriers emerged accordingly. An overarching thematic tension was evident, based on a view of self-care as revolving around the disease or evolving in the lives of people with diabetes. This tension has implications for health professionals and for those involved in policy development related to self-care.