decision making about their self-care behaviors.33 Additionally, Hernandez et al34 and Paterson and Thorne35 emphasized that self-care in DM is a dy- namic process of reacting to bodily cues. Patients often try different self-care activities until they find an effective self-care approach that works within their individual context. Two recent concept analyses36,37 emphasize awareness, interpretation, and the response of patients to particular signs and/or symptoms of DM as integral components of DM self-care. Examining, scientifically, the decision making that patients use in their self-care may provide important clues as to why measuring treatment adherence and other routine self- care behaviors do not fully explain DM self-care and its relation to health outcomes. The distinction be- tween routine self-care behaviors and nonroutine self- care decision-making behaviors is well encapsulated by the categorizations of self-care maintenance and self- care management, respectively. It is important to clar- ify how these distinct components of DM self-care influence health outcomes differently.