Purpose: Diabetes mellitus has been either the fourth or fifth leading cause of death among Taiwanese adults during 1995e2015. Older adults with diabetes are at higher risk of developing diabetic macrovascular and micro-vascular complications. The purpose of this study explored the self-management experiences of middle-aged and older adults with diabetes through a focus group. Methods: Purposive sampling was used to recruit patients with diabetes from the metabolic outpatient clinics of medical centers and regional hospitals in Taiwan. Two focus groups, comprising a total of 23 participants, were employed to collect data, and group discussions were held a total of four times in an education room that was distant from clinical areas. Results: Three themes were generated from analysis of the collected data: (1) "listening to the voice of the body and observing physical changes," (2) "re-recognizing diabetes and challenges," and (3) "selfmanagement implementation dilemmas." This study provided new insights into the experiences of middle-aged and older adults in Taiwan regarding their self-management of diabetes. Conclusion: Healthcare teams should be involved in the self-management education of patients with diabetes as early as possible to reduce patients' anxiety and to develop more patient-centered, culturesensitive clinical skills. In addition to monitoring patients' self-management, healthcare professor should pay more attention to patients' successful adaptation to and coexistence with the disease.

We recommend that health care providers make proper use of support groups for family caregivers or other important individuals in the lives of people with diabetes to provide education, clarification, support and guidance. In addition, health care providers also need to provide clients with hypoglycaemia-related emotional support, while enhancing diabetes self-management and problem-solving skills.