Western Sydney is a diabetes hotspot with disease rates higher than the NSW average. The Western Sydney Diabetes (WSD) initiative was established in response to the growing threat diabetes poses to our community's health and wellbeing. It calls for all levels of government, the private sector and non-government partners to work together.If this 'hotspot' is not addressed, within a decade it will cause an unsustainable economic and societal burden on the state's healthcare system. Western Sydney faces some daunting issues as the social determinants of health that promote healthy eating, active living and social inclusion are not working favourably to prevent diabetes and its progression.