Objective To identify the range of self-management activities people diagnosed with diabetes engage in to manage their disease, the frequency of use, and whether self-management practices change over time. Methods A systematic review of the literature was undertaken. Thirty-two studies identified through electronic databases met the inclusion criteria and were included in the review. Results The study found that people living with diabetes undertake regular self-management activities and that compliance with medication regimes is high. Adherence, however, varied with respect to blood glucose testing, diet, physical activity and foot care. Levels of physical activity were not found to change over time. Evidence suggests that some people with diabetes modify their self-management practices in response to factors such as holidays. Conclusions The review suggests that the majority of people with diabetes self-manage, although there is variation in adherence to key self-management activities. How self-management practices change over time and whether this impacts on health outcomes is an area for future research. What is known about the topic? Self-management is key to diabetes control; however, many papers have described adherence as variable. Although there is a growing body of knowledge on adherence to self-management strategies, the question of whether self-management practices change over time has not been explored. What does this paper add? This review found that adherence to medication regimes was highest of all self-management strategies, whereas considerable variation exists for self-monitoring of blood glucose, dietary changes, physical activity and foot care. The findings suggest that adherence varies under special circumstances; however, the question of whether self-management practices change over time remains unanswered. What are the implications for practitioners? Continued efforts are necessary to promote awareness of the importance of diabetes self-management and adherence to regular self-care.