This research delves into diabetes self-management practices among patients at District General Hospital Polonnaruwa's medical clinic. A comprehensive dataset from 100 participants over two weeks reveals insights. The majority were male (77%) from the Sinhala Buddhist community (97%). Education varied from up to O/L qualifications (53%) to no formal education (26%), while 63% were employed and 27% unemployed. Challenges in dietary adjustments, physical activity, and timely insulin administration were evident. Focus on dietary patterns highlighted the need to reduce rice consumption and increase protein and vegetable intake. Physical activity was evenly distributed, with 50% inactive and 50% active. Awareness of hyperglycemic management was notable, but gaps existed in foot care consciousness (41%) and recognizing familial diabetes history (28%). Complications like retinopathy (65%), neuropathy (33%), and nephropathy (22%) were significant concerns. Therapeutic drug familiarity was proficient, with 89% knowing oral hypoglycemic drugs and 21% understanding insulin. Education played a crucial role, shaping hygiene and self-management awareness. Complications were pertinent, but neuropathy and nephropathy instances were comparatively lower. Contributory factors—personal hygiene, physical activity, family support, dietary habits, and foot care—shaped diabetes self-management. Education emerged as a catalyst. Specific domains need attention for optimal outcomes. Dietary paradigms gain significance, emphasizing protein and vegetable integration. Surprisingly, 54% demonstrated commendable dietary practices, challenging previous claims of suboptimal approaches among Type 2 Diabetes Mellitus participants (56.7%). This study underscores education's pivotal role and the importance of addressing self-management domains for improved diabetes outcomes.