Background: Diabetic patients must be managed comprehensively to normalize blood sugar levels for a long time, as it has an impact on diabetes distress. Self-management is an essential intervention to keep the patient’s blood glucose levels stable. Moreover, people with diabetes who have poor self-acceptance may develop a negative view of themselves, which can affect diabetes self-management. Thus, this study aimed to determine the relationship between self-acceptance and self-management of diabetes distress among patients at Roemani Semarang Hospital. 
Methods: This quantitative study used an observational approach. The sample consisted of 52 respondents who were treated at the Roemani Semarang Hospital, in Indonesia. The sampling technique used was consecutive sampling. Self-acceptance was measured by the acceptance of illness scale (AIS), which consists of eight questions developed by Felton with a Cronbach’s α of 0.861. Self-management was measured by the diabetes self-management questionnaire (DSMQ) developed by Schmitt, which consists of 16 questions with a Cronbach’s α 0.628. Moreover, diabetes distress was measured by the diabetes distress scale (DDS), which consists of 17 items developed by William Polonsky with a Cronbach’s α 0.840. 
Results: Most diabetic patients had moderate self-acceptance, with 41 respondents (78.9%), good self-management, with 39 respondents (75%), and moderate diabetes distress, with 32 respondents (61.5%). Therefore, self-acceptance and self-management had a relationship with the incidence of diabetes distress (P=0.001).
Conclusion: Diabetes distress must be treated in diabetes patients because it impacts self-management. Additionally, an approach to increasing self-acceptance is necessary, as it also affects diabetes distress. Further studies are needed to explore self-acceptance as a mediator between self-management and diabetes distress.