Diabetes complications and comorbidities present challenges and opportunities for the diabetes educator when assisting the individual with diabetes to set realistic self-care goals. This chapter utilizes self-care behaviors as a framework for educational considerations, taking into account many of the common diabetes complications including myocardial infarction, heart failure, visual impairment, diabetic kidney disease, and peripheral neuropathy. Optimizing self-care can be overwhelming for the individual with diabetes complications and comorbidities. Assisting the individual to identify barriers, prioritize needs, and develop strategies to overcome those barriers move them closer to the goal of optimum self-care.