Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior andQuality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination ofthe Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabeteswho regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesizedmodel and calculate the direct and indirect effects of factor affecting the participants’ DSM behavior and QoL. Results: The supportedhypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (g=.55, p=.007). 2) The variablesthat had a direct effect on DSM behavior were DSM information (g=.15, p=.023), DSM confidence (g=.25, pqqqlt;.001), and autonomous motivation(g=.13, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (g=.33, pqqqlt;.001). Conclusion: The major findingsof this study are that supporting patient’s autonomous motivation is an influential predictor for adherence to DSM behavior, and integrativeintervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continueDSM behavior and improve QoL.