The prevalence of diabetes in the U.S. Hispanic population has grown to epidemic proportions. The prevalence of diagnosed diabetes in Hispanics is 1.9 times higher than that in Caucasians. Diabetes is diagnosed at an earlier age, and, for a multiplicity of reasons, Hispanics suffer from higher rates of diabetic complications and mortality. The etiology for the higher prevalence of diabetes and its complications is not clear, but it is thought to be related to genetic and environmental factors. In this manuscript, we review recent epidemiologic information on the prevalence, pathophysiology, and complications of diabetes, as well as the recommendations for the management of Hispanics with type 2 diabetes.