The nephrologist in charge of the Samoa National Kidney Foundation is calling for better monitoring for early signs of diabetes.
Dr Kushma Nand says the health system's failure to do this is the major cause of renal failure in Samoa.
Dr Nand told the Samoa Observer there is no monitoring in place and this is vitally needed in order to intervene at an early stage of the disease.
Since last December Dr Nand has headed the dialysis unit at the Samoa National Kidney Foundation but not on a full-time basis.
She flies over from New Zealand to assess patients and other work periodically - free of charge.
Dr Nand pointed to a study done in 2004 which revealed that probably up to one in five people in Samoa are diabetic.
She said of people on dialysis, diabetes is the primary cause of renal failure for 75 percent.
And she believes these cases could have been prevented if they had been monitored and treated properly.