Over 34 million Americans are affected by type II diabetes. About 96 millions Americans have prediabetes and are at high-risk of developing type 2 diabetes. Diabetes is the most costly chronic disease in the United States due to the high number of Americans affected, the associated medical expenses, and the indirect costs. Diabetes has an annual cost of $412 billion. Those with diabetes pay twice as much for medical care as those who don’t have it. A majority of those with type II are from historically marginalized groups of race, are of lower socioeconomic status or live in rural communities. Diabetes rates are twice as high in American Indians and Alaska Natives (AIAN) than the national average. AIANs are also 1.8 times more susceptible to diabetes death compared to people of other races. Appalachian residents are also 1.4 times as likely to suffer from diabetes as those in other regions, and they have less access to healthcare than the majority.