In the past two decades South American countries have experienced important sociopolitical changes and major economic crises. The associated demographic, epidemiological, and nutritional transitions have exerted a profound impact on the precarious health care systems in most countries of this region. At present, the mean prevalence of diabetes mellitus in South America (6–9% of adult population) does not seem to be different to that registered in many other countries of the world. However, some serious problems cast a shadow of extreme worry:

1. The number of patients with diabetes will possibly double in the next 20 years;

2. Nonequity is a constant in the health care delivery systems of this region and thus a large number of people are effectively excluded from most health care services;

3. The highest prevalence of diabetes is found in the ethnic minorities and disadvantaged populations;

4. Few important efforts are directed toward increasing early detection and administering appropriate treatment; as a consequence it is expected that the number of patients with complications will rise drastically;

5. The burden posed by the increasing number of cases and the elevated cost of treating the disease and its complications will exceed the possibilities of the already meager health budgets of most countries in the region.

In spite of this reality, there are efforts arising from public and privet sectors in order to provide epidemiological data, diabetes education, and better diabetes care in the region. These initiatives are achieved thanks to commited persons and institution working to improve the health of the population.