Diabetes, as it has increasingly affected Dakota (Sioux) in a North Dakota community, is deliberated upon by patients in commentaries that range beyond the more familiar biomedical "boundaries" of a given health condition. These commentaries--or "narrative reconstructions"--following Williams and Wood's (1986) considerations of patients "making sense" of illness and the disruption it may cause, touch upon larger concerns of Dakota regarding culture history and identity. While individuals' interpretations regarding etiology, illness experience, and efficacy of treatments vary, diabetes emerges as a symbol that conveys meaning at many levels. That diabetes treatment may impinge on customary foodways makes imagery of diabetes perhaps more salient. Health workers, trained within the "culture of biomedicine" (Hagey 1984), may learn to recognize key elements in such narratives for cooperative efforts in diabetes education and treatment.