The International Diabetes Federation estimates that the number of people with diabetes worldwide is 171 million and projects that number will increase to 334 million by the year 2030 (1). Most of the increase will be the result of type 2 diabetes (T2DM) and disadvantaged people and those from transitional populations—people undergoing rapid change in their economies, lifestyles, and health—will be affected disproportionately (Fig. 1). Transitional and disadvantaged populations may include people of any race or ethnicity, but those most at risk for T2DM are Asians, Pacific Islanders, Australian Aborigines, African Americans, Hispanics, and Native Americans. These particular populations are also at higher risk for developing diabetic nephropathy (DN). Factors contributing to the high rate of DN in these transitional and disadvantaged populations may include differences in access to health care, genetic susceptibility, and environmental exposures.