Diabetes mellitus is common in the South Asian population residing in the Indian diaspora. Cardiovascular disease is a major cause of death in the Indians of South Africa. This study reviews the epidemiology and clinical pattern of diabetes mellitus in the South African Indian population from the available published literature. The concept of insulin resistance in the Indian population group appears to be interesting and has a novel approach towards explaining the high risk of cardiovascular disease. Dietary factors and physical inactivity could contribute to diabete mellitus.