Attitudes were evaluated according to the 'Personal Responsibility Attitude Assessment System' (PRAS), which allows grading of patients' attitudes into five levels of perception of responsibility toward their disease. In 59 diabetics evaluated in this study, no sex difference was observed in attitude level, but more of those aged less than 40 years showed lower attitude levels (levels 1-4) than those aged 40 years or over (P less than 0.01). Of those aged 40 or over, more patients with a high attitude level (level 5) had had diabetes for 10 years or longer than those with low attitude levels (levels 1-4) (P less than 0.05). Among those not treated with insulin, patients with a low attitude level showed higher hemoglobin A1 (HbA1) levels (P less than 0.01) and more frequently had retinopathy (P less than 0.05) than patients with high attitude levels. As for women, low attitude level patients consumed less fruit, meat or fish, and vegetables (P less than 0.05) but more fat and sweetening agents (P less than 0.05) than high attitude level patients. These results suggest an association between the attitude level of diabetic patients evaluated by PRAS and the degree of their self-care. Evaluation of patients' attitudes is important in predicting the response to educational intervention in diabetes.