The near-epidemic proportions of diabetes mellitus and the metabolic syndrome over the past years are widely ascribed to a changing socioeconomic environment that contributes to excessive nutritional intake and sedentary lifestyle. Paradoxically, this gives room for expectations, because timely lifestyle and dietary intervention could decelerate the progression of diabetes, reduce the rate of development of cardiovascular complications, and reduce costs associated with treatment and rehabilitation. This approach,however, depends on the development of tools that allow precise estimation of risk of cardiovascular complications before the onset of diabetes mellitus and the risk of developing type 2 diabetes itself. This article reviews the progress that has been made toward reaching these goals based on the results of the PROspective Cardiovascular Münster (PROCAM) study.