Diabetes has become a major health problem in developing countries, where non-communicable conditions are rapidly overtaking communicable diseases as the most common cause of death. Recent World Health Organization (WHO) projections suggest that over the next two decades, the largest increase in the numbers of people with diabetes will be seen in the economically productive 20- to 45-year old age group in developing countries. Indeed, India is already a world leader, with over 35 million people with diabetes – a number that is predicted to increase to around 80 million by 2030. Initiatives to address the burden of diabetes in India include the ambitious large-scale prevention and awareness programmes being co-ordinated in Chennai by the Madras Diabetes Research Foundation.