Diabetes affects one in 20 adults worldwide and 333 million cases are projected worldwide by 2025.1 Treatment can prevent some of the microvascular and macrovascular complications, but diagnosis is often delayed until complications present,2 so attention has focused on prevention and early screening. Two strategies currently exist for reducing the onset of diabetes—lifestyle interventions and drugs.

The Diabetes Prevention Program Research Group study found that lifestyle interventions delivered over 2.8 years reduced the incidence of diabetes by 58%.3 A similar reduction in risk was found in a Finnish study of 522 people at risk.4 The problem is that these interventions are labour intensive—one study needed 16 one to one sessions delivered by case managers to achieve target weight reduction and exercise levels.3 Although lifestyle interventions produce successful results in research settings, they are difficult to replicate even in well funded healthcare systems.

Considerable interest has focused on the prevention of …