Diabetes is a growing health problem and risk increases with age. Self-care is an important part of treatment. The aim of this qualitative systematic literature review was to investigate how older patients with diabetes experience self-care. A systematic literature review relating to older patients, diabetes and self-care was conducted. Systematic searches were carried out in the CINAHL, PubMed/MEDLINE and PsycINFO databases. The results show that older patients with diabetes are mainly concerned with the issues of blood glucose testing, dietary requirements, information about diabetes, motivation and support. To support safe self-care for older patients with diabetes, nurses need opportunities to increase their knowledge and reflection about diabetes and safe self-care support. Further research is needed to identify how nurses can promote older patients’ self-care and quality of life in the context of a person-centred approach.