The diabetic patient receiving nutritional support presents a particular challenge to critical care nurses and other members of the health care team. Typical protocols concerning TPN administration must be reevaluated given the special considerations associated with the pathology of diabetes mellitus. These patients are particularly susceptible to the development of acute complications including those associated with glucose metabolism abnormalities and electrolyte imbalances. In addition, diabetic patients receiving TPN have the added stress of an acute illness complicating a chronic illness. An understanding of the interrelationships between the pathophysiology of diabetes mellitus and the stress response will provide the nurse with the background information necessary to meet the challenges imposed by TPN administration. The critical care nurse will be able to recognize early signs and symptoms of complications and implement appropriate nursing interventions. An overview of primary nursing diagnoses, goals, and interventions has been presented and will apply to most patients receiving nutritional support. Individualized care plans can now be formulated as an extension of the basic plan, thus ensuring optimum nursing care to the diabetic patient receiving nutritional support.