Epidemiological studies on diabetes mellitus (DM) have been conducted in the Caribbean for more than four decades. In Jamaica, the estimated prevalence of DM among adults ranged from 1.3% in 1960 to 17.9% in 1995. Part of the variation in estimates has been due to the differing age groups that have been studied. The 2007–8 Jamaica Health and Lifestyle Survey (JHLS-2) reported prevalence estimates of 7.9% for diabetes mellitus and 2.8% for impaired fasting glucose in persons 15–74 years old. Across the Caribbean, the overall prevalence of diabetes mellitus is estimated at about 9%. In addition to the high burden of prevalent diabetes, there is also a high burden of complications. In Barbados, the incidence of diabetic foot complications has been found to be second only to a population of Native Americans in Najavo. The Barbados Eye Study revealed that among persons 40–84 years old in Barbados, 28.5% had evidence of diabetic retinopathy on fundus photographs. Regionally, the impact of DM on cardiovascular diseases (CVD) has not been adequately reported. With regards to diabetes care, poor control rates and inadequate surveillance for complications have been reported in Barbados, Trinidad and Tobago, Tortola and Jamaica. The JHLS-2 showed that while more than 70% of persons with diabetes were aware of the condition less than 50% were under control. In light of the expected increase in the number of people with diabetes mellitus, healthcare planners and researchers will need to redouble their efforts to both prevent as well as limit the impact of diabetes mellitus and its complications in Caribbean populations.