Diabesity and its common precusor, the metabolic syndrome is becoming an epidemic worldwide and at an ever younger age. It is already the major precursor of death and will become dominant in deprived countries very soon. All diseases are due to genomic predisposition and expressed due to interaction with lifestyle, particularly the thrifty genotype and diet. This affords a huge opportunity for prevention. Advances in molecular medicine and the information explosion has resulted in better understanding of diabetes at the molecular level and the development of more effective agents. Very recently bariatric surgery has been shown to cure established diabetes in more than 90% of patients.