In 2012, 8.2 percent (or about 52,000) of adults in Delaware reported being advised by their medical provider they have pre-diabetes. Many additional Delawareans have undiagnosed pre-diabetes. Lifestyle changes such as increasing physical activity, modest weight loss and healthier eating can prevent or delay the development of type 2 diabetes. Evidence-based programs have been developed to reduce the prevalence of the disease by providing interventions at the stage of pre-diabetes detection and are cost-effective or provide cost-savings. One such evidence-based preventive service is the Diabetes Prevention Program (DPP), developed by U.S. Department of Health and Human Services. Delaware is fortunate to be one of two states with statewide implementation of the DPP program. Increasing the identification of pre-diabetes in primary care is an important first step in preventing diabetes. Enhancing successful referrals to the DPP is also critically important to decrease the burden of diabetes. Many partners are working together in Delaware to support these improvements.