The nutritional prevention of most diabetes may start as early as fetal life with maternal nutrition. Reduced food variety, excessive refining of food and saturated fat, with sedentary lifestyles unmask predispositions to non insulin dependent diabetes and increase the likelihood of complications. Food pattern is important, with preference for small, more frequent than large infrequent meals being an advantage. For short term (acute meal response) and longer term glycaemic control, as well as an aid to satiety, low fat glycaemic index foods are encouraged. Some sucrose and alcohol are compatible with good glycaemic control. Nutritional behaviours are more likely to change if the socio-cultural context is respected and negotiation rather than prescription is used. Informed self monitoring reinforces adherence.