Diabetes has emerged as the modern day epidemic that is currently affecting over 220 million people worldwide and claiming at least 1.1 million lives in 2005 alone. The rise in diabetes is largely attributed to the epidemic of obesity together with sedentary lifestyle as well as unhealthy dietary habits. Despite evidence that glycemic control as well as control of other cardiovascular disease (CVD) risk factors such as hypertension and dyslipidemia decreases morbidity and mortality in the diabetic population, control of glycemia and other CVD risk factors remains largely suboptimal making the concept of prevention of diabetes very appealing to control CVD risk, especially that such a risk is already increased in people in the prediabetic stage. Several large controlled trials have been completed testing various options for diabetes prevention. In this paper we present an update on prevention of type 2 diabetes highlighting the major recent trials completed to date in this very important area of investigation.