People receiving a diabetes diagnosis must absorb information, change habits and adopt new behaviours almost immediately. Guidelines thoroughly cover the medical aspects of initial management however the information and psychological needs of patients are not addressed. This study aimed to identify diabetes patient needs for information and emotional support at the time of diagnosis. A sample of 1159 patients completed a questionnaire which assessed their concerns and information preferences at the time of diagnosis (response rate 64.4%). A sample of 100 general practitioners (GPs) were interviewed about their perceptions of these issues using a subset of items from the patient questionnaire. The diagnosis of diabetes was distressing for 60% of responders and 23% wanted more emotional support. Immediate issues such as injections were major concerns for patients and GPs correctly identified these. However GPs significantly overestimated complications as a concern for patients at diagnosis. Patients preferred diabetes educators and courses as sources of information. Satisfaction with information at diagnosis was high (80%), however younger patients were dissatisfied with their discussions concerning diabetes therapy. The findings suggest that clinicians giving a diagnosis of diabetes should: (1) be aware of patient variability in needs for emotional support and information preferences, (2) ask patients for their preferences and offer choices if available and (3) provide more information about treatment and increase patient involvement in discussions about therapy.