In this study, the social theory of identity was used to gain a better understanding of the complex process of how individuals adjust to having insulin-requiring diabetes. Semistructured interviews were conducted with 30 individuals to explore issues related to their personal experience with diabetes. Narrative methods were used to analyze the data. An exploration of participants' stories revealed significant identity issues underlying their interpretation and management of diabetes. The diagnosis of diabetes was conceptualized as an assault on personal identity. This initial disruption was followed by a process of negotiation whereby individuals grappled with identity issues to adapt to the condition and integrate it into their lives. This process was socially shaped and influenced individuals' perceptions of their diabetes management. The main concepts examined in this paper are diagnosis and identity, identity and treatment management, and identity and the ongoing nature of adjustment. The implications for diabetes education are presented.