Diabetes mellitus is a common condition affecting people of all ages and personalities. Treatment is complex and demands considerable personal resources in the sufferer if control of blood sugar is to be achieved and the risk of serious short and long term complications minimised. Some common patterns of difficulty with compliance amongst insulin-dependent diabetics are identified and discussed. The literature on the compliance issue and on psychotherapeutic intervention in poorly compliant diabetics is briefly reviewed. The treatment is described of six patients using a form of brief focussed psychotherapy in which analytical and cognitive methods can be combined. The difficulties with compliance are specifically addressed in the wider context of the individual's life problems. This is part of an ongoing research project in which the efficacy of psychotherapeutic and educational interventions is being compared in such patients, in the hope of helping patients avoid later complications and make better use of medical services.