Objective: To examine whether the communication process between diabetes health professionals and people intensively self-managing their type 1 diabetes influenced behavioural change. Design: Telephone interviews to provide insight into the communication process and its influence on diabetes intensive self-management behaviour. Setting: Interviewees' own homes. Method: A sub-group of 10 people from a questionnaire survey were contacted to participate in a telephone interview. The taped interviews were transcribed verbatim and analysed thematically, both manually and using computer software, to identify common themes in the texts. Results: The process of change and maintenance of diabetes self-management behaviours for the majority of participants was enabled by current available intensive treatments and information, education and support from health professionals in primary care, rather than diabetes health professionals specifically. Conclusions: Individuals intensively self-managing their diabetes have a high degree of motivation to improve glycaemic control, but also require the assistance of health professionals in primary and secondary care to enable this to take place. (Contains 1 table.)