Objective: To determine factors contributing to successful diabetes self-management in Appalachia, as evidenced by daily blood glucose monitoring. Methods: A telephone survey (N = 3841) was conducted to assess health status and health care access. The current investigation is limited to the subset of this sample who report having diabetes (N = 529). Results: A multivariate logistic regression model established that having attended a diabetes education class (P less than 0.01) was the most significant predictor of successful diabetes self-management. The inability to pay for care, demographic variables, and health risk indicators were not found to be significantly related to self-management. Conclusions: This study identifies the role of education in successful diabetes self-management for patients in the Appalachian region.