INTRODUCTION: Providing optimal care to complex patients can push pharmacists into an unclear gray area, requiring the use of clinical judgment, critical thinking, and problem-solving. Two diabetes-focused elective courses were developed to better prepare student pharmacists for working in this gray area on advanced pharmacy practice experiences (APPEs) and beyond. OBJECTIVES: The primary objective was to evaluate how completion of a diabetes elective course affected student pharmacists' attitudes and perceived abilities, knowledge, preparedness, and self-efficacy in providing patient care in the real world. METHODS: This mixed-methods study evaluated two diabetes-focused pharmacy elective courses to determine outcomes on students a year later and to determine the most impactful course elements. A survey was sent to graduating pharmacy students to compare perceptions of knowledge and abilities, attitudes, and self-efficacy among those who did and did not take the electives. Elective-taking students were invited to participate in virtual interviews to further garner their experiences in caring for patients with diabetes and reflections on the course. RESULTS: Fifty-four students (42.5 %) completed the survey. Generally, completion of either elective appeared to be statistically related to perceptions of knowledge, skills, and behavioral attitudes, whereas no difference was found for self-efficacy. Eight students participated in one-on-one interviews and two major themes emerged of dealing with the gray areas of patient care and preparation for APPEs. CONCLUSION: The study findings suggest that the diabetes electives helped students to be better prepared for their APPE experiences and ultimately take care of patients with diabetes.