Although clinical trials have shown that lifestyle modifications reduce the risk of type 2 diabetes, translating lessons from trials to primary care remains a challenge. The aim of the study was to evaluate efficacy and feasibility of primary care-based diabetes prevention model with modest resource requirements in rural Australia. Three hundred and eleven subjects with at least a moderate risk of type 2 diabetes participated in a combined dietary and physical activity intervention. Clinical measurements and fasting blood samples were taken at the baseline and after intervention. After 3 months intervention, total (change -3.5%, p<0.001) and LDL cholesterol (-4.8%, p<0.001) plasma levels as well as body mass index (-2.5%, p<0.001), weight (-2.5%, p<0.001), and waist (-1.6%, p<0.001) and hip (-2.7%, p<0.001) circumferences reduced significantly. A borderline reduction was found in triglyceride levels (-4.8%, p=0.058) while no changes were observed in HDL cholesterol (+0.6%, p=0.525), glucose (+0.06%, p=0.386), or systolic (-0.98%, p=0.095) or diastolic (-1.06%, p=0.134) blood pressure levels. In conclusion, a lifestyle intervention improved health outcomes - especially obesity and blood lipids - in a population at high risk of developing type 2 diabetes. Our results suggest that the present model is effective and feasible to carry out in primary care settings.