BackgroundDiabetes is a huge growing problem, and causes high and escalating costs to society. Self- care practice for adults with diabetes is not well addressed in sub-Saharan Africa including Ethiopia. To prevent serious morbidity and mortality, diabetes treatment requires a commitment to demanding self-care practice. This study aimed to assess self- care practices and its associated factors among adults with diabetes in Dire Dawa public hospitals of Eastern, Ethiopia.MethodsA cross-sectional study was conducted among 513 adults with diabetes. The study participants were selected through systematic random sampling. Data were collected from February 1st to March 1st, 2018. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 3.3.1 and exported to SPSS version 22.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Good self-care was defined based on mean calculation; a result above the mean value had a good self-care practice, and a P-value of < 0.05 was considered to declare a result as statistically significant.ResultThe result of the study showed that 55.9%, (95% CI: 51.4, 60.3) of participants had good self-care practices. Good self-care practice was associated with having family support, treatment satisfaction, diabetes education, having glucometer, higher educational status, duration of the disease, high economic status, and having good knowledge. Self-care practice was significantly associated with good diabetes knowledge (AOR = 2.14, 95% CI: 1.37, 3.35), family support system (AOR = 2.69, 95% CI:1.56, 4.62), treatment satisfaction (AOR = 2.07, 95% CI:1.18, 3.62), diabetes education (AOR = 2.21, 95% CI: 1.35, 3.63), high economic status (AOR = 1.89, 95% CI: 1.01, 3.48), having glucometer,(AOR = 2.69, 95% CI:1.57, 4.63),higher educational status (AOR = 2.68, 95% CI: 1.31, 5.49), and duration of disease greater than 10 years AOR = 2.70, 95% CI: 1.17, 6.26).ConclusionIn this study, a large number of adults had poor self-care practices which are very significant in controlling diabetes. Providing diabetes education, about self-care practices to the respondents and their families should be considerable.