Asking about diet and exercise may keep a provider and their patients ahead of the diabetes-prevention curve. In a head-to-head comparison over 15 years, diet and exercise outperformed metformin in preventing diabetes in patients at high risk. Lifestyle interventions were more powerful in preventing or delaying diabetes development during the original three-year Diabetes Prevention Program (DPP) and remained more powerful over the entire 15-yr study. If you have patients who are pre-diabetic or now have Type 2 diabetes, are you inquiring about their diet and exercise? The article published in The Lancet (Diabetes & Endocrinology) indicated that of the patients offered “lifestyle training” after the DPP reduced their incidence of diabetes by 27% vs. just 18% for those patients on metformin alone.