Diabetes mellitus is reaching epidemic proportions. In 2014, the total prevalence of diabetes was estimated to be 442 million people worldwide. Due to the aging population and continued increase in obesity rates, the prevalence is expected to rise to 592 million by 2035. Diabetes can lead to several complications, including cardiovascular disease, stroke, peripheral arterial disease, nephropathy, neuropathy, retinopathy, lower extremity amputation and musculoskeletal impairments. Up to 80% of patients referred for outpatient physical therapy have diabetes or are at risk for diabetes. Physical therapists are key members of the healthcare team: prescribing physical activity for the treatment of diabetes and other chronic diseases such as cardiovascular disease and osteoarthritis. Physical therapists can screen for risk factors for diabetes and diabetes-related complications that modify traditional musculoskeletal exercise prescription. Physical therapists must advocate for regular physical activity as a key component for the treatment of chronic diseases in all patient interactions. This report 1) describes the diabetes epidemic and the health impact of diabetes and diabetes-related complications, 2) highlights the physical therapist's role as front-line provider, and 3) provides recommendations for physical therapists in screening for diabetes risk factors and diabetes-related complications and considerations for patient management. We focus on type 2 diabetes. J Orthop Sports Phys Ther, Epub 28 Nov 2019. doi:10.2519/jospt.2020.9154.