This study examines older adults’ fears of diabetes complications and their

effects on self-management practices. Existing models of diabetes self-management posit

that patients’ actions are grounded in disease beliefs and experience, but there is

little supporting evidence. In-depth qualitative interviews were conducted with a

community-based sample of 74 African American, American Indian, and White older adults

with diabetes. Analysis uses Leventhal’s Common Sense Model of Diabetes to link

fears to early experience and current self-management. Sixty-three participants identify fears

focused on complications that could limit carrying out normal activities: amputation,

blindness, low blood glucose and coma, and disease progression to insulin use and

dialysis. Most focus self-management on actions to prevent specific complications, rather

than on managing the disease as a whole. Early experiences focus attention on the

inevitability of complications and the limited ability of patients to prevent them. Addressing

older adults’ fears about diabetes may improve their diabetes self-management

practices.