The balance between paternalism and self-care in diabetes care has changed in harmony with the history of medicine. A holistic approach to illness and treatment was widespread in Denmark up to 1920s, as the Danish tradition was based on ancient medicine. New knowledge about effective diabetes treatment especially with insulin, evoked paternalism. Decades later, self-care progressed, and nurses in particular took ownership to help patients implement diabetes into their daily lifes. Self-care and empowerment became ultimate goals in diabetes care due to a number of biomedical, technological, pedagogical, and societal factors that in different ways led to this development. We discuss the pendulum swing between paternalism and self-care to favour self-care, making it mandatory, but what is worse is the unde-served blaming of the patient decisions and lifestyle for his or her. Future challenges include cross-sectoral and professional cooperation to create a worthy balance between patients and the health system.