American Indians and Alaska Natives (AI/ANs) experience some of the greatest health inequities of any group within the United States. AI/ANs are diagnosed with diabetes more than twice as often as non-Hispanic white Americans. Diabetes is a chronic preventable disease often associated with individual risk factors and behaviors that indicate what interventions are needed to prevent or manage the disease. Individual ameliorative strategies in diabetes prevention and management do not fully address the fundamental causes and complexity of diabetes in American Indian communities. Through the application of a social determinants of health paradigm, social work has the opportunity to reframe diabetes and begin to understand it as a product of and a response to unjust conditions and environments, rather than as a disease rooted solely in individual pathology and responsibility.