Nurses' perceptions in caring for persons with diabetes have been little studied. To address this gap in the literature, a sample of nurses from a large Mid-western health care system were surveyed on nurses' perceptions of: (i) problems encountered in the care of patients with diabetes; (ii) problems encountered by patients and/or family member(s) in diabetes management; and (iii) nurses' suggested solutions. A randomly selected list of 200 registered nurses obtained from the health system's Department of Human Resources included inpatient, outpatient, emergency department, medical centre and home health care nurses. The sample was stratified to include 25% inpatient and 75% outpatient nurses. Of the 200 surveys mailed, 136 were returned (68% response rate). Twenty-four per cent of the 136 nurses reported they did not provide care for patients with diabetes. Of 103 nurses providing care to patients with diabetes, 98% were female, 91% were Caucasian, 76% were between the ages of 30 and 49 years, 57% worked in outpatient settings, 35% worked in primary care, and 42% had a bachelor's degree or higher. Of those with practice guidelines, 84% found the practice guidelines helpful. These nurses also perceived that they, as nurses, needed more education to improve their care of diabetes patients; few nurses believed it was within the scope of their practice to change treatment regimens. The perception of most nurse respondents was that acceptance of diabetes, knowledge deficits and non-compliance were primary patient problems in the management of diabetes. Nurses' perceptions of solutions to the problems centred on education of nurses and patients, and reinforcement of the importance of follow-up care.