The prevalence rates of diabetes are rising rapidly both in urban and rural India. Education is the cornerstone of diabetes care (WHO). Indian Diabetes Prevention Programs prove that Indians with impaired glucose tolerance (IGT) respond to lifestyle modification. Early improvement in glucose tolerance (normoglycemia in 6 months) significantly reduces risk of diabetes development. Spending on noncommunicable diseases (NCDs) accounts for 5.17% of household expenditure in India. Delivery of NCD screening services at home by trained community health workers is feasible. UDAY, a 5-year initiative, aims to reduce the risk of diabetes and hypertension and improve management by informing policymakers on the most appropriate community and health system-based approaches. Both lifestyle modification and metformin significantly reduce the incidence of diabetes in Asian Indians with IGT.