During the Covid-19 pandemic, debates have emerged about whether, and if so why, people of colour are more susceptible to the virus. In Canada, for example, racialised and indigenous populations have a significantly higher risk of severe Covid-19 infection and mortality [1]. This has prompted several studies to determine whether this is due to socioeconomic factors or if the genetic makeup of racialised groups places them at greater risk. As David Naylor, co-chair of Canada’s Immunity Task Force, puts it, what proportion of the higher Covid rates in Toronto’s black communities was linked to socioeconomic conditions — “and how much could be genetic?” [2]. This is the question that Arleen Tuchman seeks to address in this brilliant and thoughtful book. She exposes the “fraught relationship” (p xvii) between race and the wide health disparities between people from different racial, ethnic and class backgrounds, and provides a close look at the economic, social, cultural and political context which shapes how we understand diabetes and those who have the disease.