Non-insulin-dependent diabetes mellitus is a major health problem in American Indian communities. Indian Health Service (IHS) collects information about outpatient visits and hospitalizations and analyzes mortality in American Indians and native Alaskans. Between October 1, 1982, and September 30, 1983 (fiscal year 1983), diabetes was the second leading clinical impression for all outpatient visits of patients 15 yr and older. Discharge diagnoses confirm both microvascular and macrovascular complications. Seventy-six percent of all IHS hospitalizations during fiscal year 1983 for lower-extremity amputation also coded diabetes. In 1982, the age-adjusted diabetes death rate per 100,000 was 19.9 for American Indians and native Alaskans, compared with 9.6 for all races in the United States.