BACKGROUND: The Diabetes Nurse Specialist (DNS) is a major workforce group in New Zealand (NZ) and a pivotal member of the diabetes multidisciplinary team providing quality diabetes care and education. The National Diabetes Nursing Knowledge and Skills Framework (NDNKSF) articulates the required knowledge and skills within the specialty of diabetes in a NZ context. The NDNKSF provides a measurable means of evaluating practice and guides the development of individual nurses. The Aotearoa College of Diabetes Nurses (ACDN)(NZNO) offers an accreditation process for nurses to be recognised within the specialty. The role and function of the DNS has evolved over the past 30 years from a focus on patient education to a more expanded role of complex clinical management to help in addressing the growing prevalence of diabetes. In NZ prescribing of medicines has resided in the domain of medical or nurse practitioner scopes of practice until 2011 when a new regulation was formed under the Medicines Act. This enabled appropriately qualified DNSs in the Registered Nurse scope of practice working in diabetes care, to prescribe a range of diabetes related medicines under the supervision of a medical practitioner. METHOD: In 2011, an initial 6 month project with 12 experienced DNSs was undertaken to demonstrate that prescribing by suitably qualified DNSs was safe and effective. A second 6 month project was undertaken with a further 15 DNSs. Clinical data was collected for all contacts with data analysed and reported by an external evaluator. RESULTS: Project data demonstrated that prescribing by DNSs in the RN scope of practice was effective. Clinical measures remained stable or improved. No adverse events were reported. Positive outcomes were noted with respect to patient access, patient satisfaction, medical practitioner satisfaction and role satisfaction for DNSs. CONCLUSIONS: Prescribing under medical supervision by suitably qualified and experienced DNSs was demonstrated to be safe, effective and improved patient access. It is now being rolled out throughout New Zealand further expanding the role of the DNS in general practice and specialist diabetes services.