Recent research has demonstrated the health benefits of diet and exercise for people with diabetes. The positive results offer an optimistic future to millions of people with the condition, and the many millions more who are at risk from diabetes around the world. We now know that therapeutic lifestyle interventions are highly effective in both preventing and managing the condition. In people with Type 2 diabetes, lifestyle changes can reduce and even eliminate the need for medication. The importance of a healthy, balanced diet which is high in fresh fruit, vegetables and pulses, and low in sugar and animal fats has been demonstrated. In this article, Amy Joy Lanou and Neal D Barnard look at evidence which suggests that vegetarian regimes may be particularly beneficial in the prevention and management of diabetes.