Objective: The overall objective was to explore and describe the practice nurses’ (PNs) role, perceptions of and beliefs about diabetes management. There is little research on the PNs’ role and their approach to the delivery of diabetes care in rural and remote general practice, although the pathophysiology aspects are reported in detail.

Aims: The specific aims of the study were to:

1. Determine what was known by the term ‘practice nurse’ in relation to diabetes care.

2. Identify specific factors that relate to diabetes management and impact on the PNs’ role in rural and remote practice.

3. Ascertain diabetes education PNs feel they require to competently deliver diabetes management and education.

Method: A one-shot cross-sectional survey using self-completed questionnaires and interviews undertaken in three phases was used to collect the data: pilot test; main study; and interviews. One hundred and six surveys were mailed, and 31 responded: pilot test n = 10; main study n = 21. A face to face interview and a telephone interview were conducted with four PNs.

Results: Eighty eight percent of respondents lived in a rural location. Sixty seven percent had worked as a PN ≤ 5 years compared with 24% who had worked ≥ 15 years. Part-time work was a major problem and contributed to reduced continuity of care, effective communication and diabetes education. Most, 80% rated obesity the most common risk factor for diabetes; 15% cited cardiovascular disease. PNs’ diabetes knowledge was inadequate in key areas: short and long-term complications; diabetes screening procedures; and competency to assess patients’ self-care practices. General practitioners often acted on patient assessments performed by PNs. Participants knowledge and working relationships may affect diabetes care. A change to clinical decision-making strategies would have important economic benefits that may indicate implications for PNs’ diabetes management and education in practice.