Aims The purpose of this study was to examine the prevalence and correlates of mental and emotional health factors among a sample of American Indian (Indigenous) adults diagnosed with type 2 diabetes. Methods Data are from a community-based participatory research project involving two Indigenous reservation communities. Data were collected from 218 Indigenous adults diagnosed with type 2 diabetes via in-person paper-and-pencil survey interviews. Results Reports of greater numbers of mental/emotional health problems were associated with increases in self-reported hyperglycemia, comorbid health problems, and health-impaired physical activities. Conclusions This study addresses a gap in the literature by demonstrating the associations between various mental/emotional health factors and diabetes-related health problems for Indigenous Americans. Findings underscore the importance of holistic, integrated primary care models for more effective diabetes care.