insulin resistance and defective insulin secretion are regarded as cardinal metabolic features of type 2 diabetes, subtle abnormalities of both being evident even at the earliest stages of glucose intolerance. while insulin resistance is highly prevalent on a global basis-closely linked to obesity and physical inactivity-near-normal glucose tolerance can be maintained as long as increased insulin secretion is sufficient to counter the elevated requirements imposed by insulin resistance. management of the asymptomatic or mildly symptomatic patient with newly diagnosed type 2 diabetes starts with one-to-one advice and/or group education about the potential benefits of dietary modifications and, if feasible, physical activity.