Diabetes is a global public health concern because the incidence, prevalence and financial burden are rapidly increasing. Clinical nursing research in developing countries is rare. This study examines nurses' involvement in the management of diabetic patients in a western Kenya Hospital. A descriptive exploratory design is used, data were collected in structured interviews with 15 registered nurses using an investigator-designed instrument. Content analysis produced eight categories of nurses' involvement in managing hospitalized diabetic patients. Facilitators and barriers to managing diabetic care are presented from the perspective of the nurse, hospital, patient, family and community. Workforce redesign is needed to cope with nursing shortages.