The growing and disproportionate burden of type 2 diabetes experienced by racial and ethnic minority groups in the United States demands a refocusing of public health research and interventions if health outcomes are to improve. Public health research and practice must address the social production of diabetes, broaden the boundaries of how diabetes risk and causation are understood and articulated, and establish community health models that reflect the changing complexion and sociopolitical dynamics of contemporary urban communities. Relying on the traditional one-on-one clinical relationship that has characterized diabetes care in the past will not eliminate the diabetes epidemic in racial and ethnic communities.