Diabetes is a chronic metabolic disorder with a characteristic hyperglycemia. This elevated blood glucose causes the frequent complicalions of diabetes that often involve the vascular system. Macrovascular involvement includes coronary artery disease, cerebrovascular disease, and peripheral vascular disease. Diabetic nephropathy and retinopathy are serious microvascular disturbances, There is no cure for diabetes, so early detection and intervention are necessary to limit progression of diabetes and its complications. The advanced nurse practitioner has a vital rule in directing care for chronic conditions through education and a holistic approach to the patient as they are key to diabetes management. Standards of practice for diabetes have been defined by the American Diabetes Association. Balancing cost containment with maintenance of these standards is a challenge for health care.