“Without urgent action there certainly is a real risk of a major wipe-out of indigenous communities, if not total extinction, within this century," says Professor Paul Zimmet, director of Monash University's International Diabetes Institute in Australia.
He said the disease affected one in four indigenous adults and threatened to consume world economies and bankrupt health systems.
Professor Zimmet said Australia's Aborigines and native people in the United States and Canada were at as much risk as the Maori and Pacific Island populations.
Diabetes among the Maori population of about 500,000 is at epidemic proportions according to Professor Chris Cunningham, of Massey University's Research Centre for Maori Health.
It is reported to account for 20 per cent of all Maori deaths compared with 4 per cent of the rest of New Zealand's population.
Professor Cunningham said Maoris and their Polynesian cousins from South Pacific island states living in New Zealand are more susceptible to the disease because they are not physiologically accustomed to the Western lifestyle and diet.
"The reality is a Big Mac hurts Maoris more than it hurts Caucasians," he said.
Indigenous people were particularly at risk of developing Type 2 diabetes, which was primarily caused by obesity, because of the rapid transition to Western diets and lifestyles.
The "thrifty gene" allowed communities of hunter-gatherers to store fat in times of feast for survival of famines, but modern lifestyles provided continuous "feasts" and less exercise, according to experts.
Complications of Type 2 diabetes, now being found in indigenous children as young as six years old, include increased risk of heart disease, stroke and kidney disease.
Canadian diabetes expert Professor Stewart Harris has echoed the sentiments.
He says with up to half the adult populations in some indigenous communities affected, diabetes posed a serious threat to their survival.
"The rapid cultural transition over one to two generations of many indigenous communities to a Western diet and sedentary lifestyle has led to diabetes replacing infectious diseases as the number one threat to their survival," he said.
The experts said because dramatic changes to indigenous health had happened relatively quickly and were largely environmental; it was likely the trend could be reversed with appropriate management.
Obesity has reached pandemic proportions throughout the world, not just in indigenous communities, and is the greatest single contributor to chronic disease, the 10th International Congress on Obesity heard in Sydney in September.
The world now has more fat people than hungry ones, according to World
Health Organisation figures, with more than a billion overweight people compared to 800 million who are undernourished.