There is significant disparity between the prevalence of diabetes in Native Hawaiians and Pacific People (includes Pacific Islanders and Filipinos) in comparison with other ethnic groups in Hawaii. In this article, prevalence, risk factors, complications and intervention studies are reviewed. Native Hawaiians and Pacific People have significantly higher prevalence rates of diabetes in comparison to other ethnic groups in Hawaii. They also have higher prevalence rates for the risk factors and complications associated with diabetes, such as obesity and end stage renal disease, respectively. Although the reasons for these disparities are complex and not clearly understood, literature suggests that genetics, acculturation, lifestyle, and cultural beliefs may be related. There is also a lack of specific research on diabetes in Native Hawaiians and Pacific people. Future research needs to include the collection of more comprehensive data on age, ethnic group and socioeconomic status.