The most efficient way to manage diabetes and its complications is to prevent diabetes. Recent studies have convincingly demonstrated that prevention of diabetes and its complications are possible and cost effective. Life-style interventions and also early pharmacological preventive strategies have yielded a 25-75% diabetes risk reduction and an even more promising reduction in cardiovascular risks. These findings offer the evidence-base for diabetes prevention, but essential is the delivery of intervention into our societies. The challenge, therefore, is the management of prevention and intervention programs considering scientific aspects and practical requirements during implementation. This can only be addressed in a coordinated interdisciplinary setting and across sectors which requires the development of a comprehensive, integrated prevention management program also on an European level. Pharmacies have to play an important role in this concept because of their widespread distribution and the frequency of pharmacy visits of the general population. They should be established as places where patients can continuously offer risk assessment including recommendations on how to prevent the disease. Developing the role of the prevention manager and continuous evaluation and quality control are key factors in performing high quality intervention and care. Community pharmacies could take an active part in this prevention program, its evaluation, and quality assurance. Implementing structured prevention programs will enable nationwide prevention of diabetes mellitus without consuming large resources from health care insurances. This process will be challenging and time consuming, requiring many partners but resulting in a profitable "health" investment.