Background: Compared to European-origin populations, prevalence of diabetes is higher among African-origin populations in the UK, USA and Australia.African-origin populations with diabetes also have poorer outcomes in relation to glycaemic control and risk of developing microvascular complications.In spite of these striking variations in diabetes related outcomes, comparatively little is known about how these populations compare in the interpretation of diabetes and to what extent such interpretations may influence patients self-management behaviours or indeed, their metabolic control outcomes.This study aimed to investigate any variations in illness perceptions and the extent of adherence to self-management recommendations between African and European-origin patients with type 2 diabetes.The study also examined the extent to which perceptions about diabetes influenced self-management behaviours among African-origin populations.Methods: Participants in the study were black African, black Caribbean or white British Adults with type 2 diabetes who could consent to participation.Clinical data (HbA1c and BMI) were extracted from medical records whilst data on illness perceptions and self-management of diabetes were collected using validated questionnaires.Ethnic variations in illness perceptions, self-management and glycaemic control were investigated using analysis of variance/covariance whereas the role of illness perceptions on self-management was investigated using univariate and multivariate regression techniques.Results: Initial analysis showed that black African participants had poorer glycaemic control compared to their white British counterparts.Compared to black Caribbean and white British black Africans generally reported higher adherence to diabetes self-management recommendations.Significant variations were observed among groups in relation to patients perceptions of the timeline, treatment control, illness coherence and consequences of their diabetes.Illness perceptions explained significant proportions of variations in self-management behaviours among African-origin populations.Patients perceptions about the timelines, personal control, emotional feelings and consequences contributed significantly to the variations in self-management among African-origin patients.Conclusions: Important variations exist between ethnic groups in relation to their self-management behaviours as well as their interpretations about diabetes.Carefully formulated illness perception-based interventions may enhance desirable self-management behaviours in African-origin populations with diabetes.