Aboriginal communities in industrialized countries have high rates of diabetes and related complications, but few resources to address them. This book explores the care they receive, the barriers they face and the challenge health systems face in making care better. The first part systematically reviews the literature on quality of diabetes care in aboriginal communities and interventions to improve care. This is followed by an in-depth exploration of the barriers to diabetes care in several remote communities in Northwestern Ontario. This analysis informs the design of an intervention to improve cholesterol management in diabetes which is then tested in a rigorous controlled trial. The text concludes with an analysis of the implications for efforts to stem the rising tide of diabetic complications in aboriginal communities. This work is relevant to anyone interested in improving health services for chronic disease in resource-constrained settings.