In the late 1980s, pediatric endocrinologists at the Children’s Hospital in Winnipeg began to notice a new cohort appearing in their clinics for young people with diabetes.

Indigenous youngsters from two First Nations in northern Manitoba and northwestern Ontario were showing up not with type 1 (or insulin-dependent diabetes), but with what looked like type 2 diabetes, until then a condition that was restricted to people much older. Investigation led the doctors to learn that something similar had become a medical issue among young people of the Pima Indian Nation in Arizona though, to their knowledge, nobody else.

But these youth were just the tip of the iceberg. Over the next few decades more children would confront what was turning into not only a medical but also a social and community challenge.

Diagnosing the Legacy is the story of communities, researchers, and doctors who faced—and continue to face—something never seen before: type 2 diabetes in younger and younger people. Through dozens of interviews, Krotz shows the impact of the disease on the lives of individuals and families as well as the challenges caregivers faced diagnosing and then responding to the complex and perplexing disease, especially in communities far removed from the medical personnel a facilities available in the city.