The Hispanic or Latino population is the largest minority group in the United States, currently representing 13.7% of the total U.S. population. Hispanics or Latinos usually suffer from higher rates of type 2 diabetes, obesity, metabolic syndrome, and their multiple vascular complications. Inadequate nutrition and reduced physical activity in the setting of an increased genetic predisposition to type 2 diabetes have contributed to the inexorable rise in metabolic abnormalities in Hispanics in the United States, which now affect many children and adolescents. It is evident that multiple medical, cultural, and socioeconomic factors influence the development of diabetes, its course, and its consequences. Our health care system is barely prepared to face the challenge of managing diabetes in this high-risk group. Culturally oriented clinical care, education, outreach and research programs are needed to better identify the challenges to create opportunities to improve the lives of Hispanics or Latinos with diabetes or at risk for the disease.