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Finnish Diaabetes Prevention Study - 30 min. walking/day
DPP - Life-style modification 58% effective in preventing diabetes vs 31%  for metformin.
Weight loss is difficult to achieve and maintain. 
Can be done.
New medications are being developed to assist with this.
Life-style modification programs do not necessarily require professional health care providers to be successful.
 
Smoking cessation is KEY.  Can be more successful with use of counselling, and pharmacologic support - Transdermal nicotine, bupropion or nortriptyline.