Book excerpt: Explains what type 2 diabetes is. Discusses the cycle of type 2 diabetes; type 1 vs. type 2 diabetes; risk factors for type 2 diabetes in American Indians; diagnostic criteria for diabetes mellitus, impaired glucose tolerance, and gestational diabetes; management and complications of type 2 diabetes; staged diabetes management; standards of care for patients with diabetes in the Indian Health Service; cultural considerations; and the importance of a diabetes support system.