This study in collaboration with the St. Kitts & Nevis Ministry of Health (MOH) investigated the prevalence of type 2 diabetes and its risk factors, the second leading cause of death in the country.Medical records of patients between the ages of 18 and 75 as of January 1, 2010 treated between January 1, 2010 and December 31, 2015 in the government-funded health centers (HCs) were eligible for inclusion (N = 2737). All HC visits (n = 4169) generated by a representative sample of patients (n = 761) were evaluated using Caribbean Public Health Association Public Health Association (CARPHA) guidelines for risk ranges.The prevalence of type 2 diabetes is 23% and is concentrated in the 45-64 year-old cohort. Though women outnumber men 3:1 in the sample, gender-prevalence rates are similar (23% and 22% respectively). There is also evidence that comorbidities are prevalent among diabetics (76%) and many nondiabetics are at risk of diabetes (20%).This study confirmed the MOH's concerns that type 2 diabetes presents local risk and brings into question historic assumptions that women are at greater risk of diabetes than men.