The risk of type 2 diabetes often builds over decades and is shaped by biological, social and behavioral factors. That preamble from a German study sets the stage for rethinking diabetes prevention. The study, appearing in the journal Nature Medicine, proposes a continuous effort through out life, with a goal of preventing diabetes long before symptoms develop. Authors say the risk of developing diabetes is shaped much earlier. Other points include restoring health rather than merely slowing the disease. They also focus on pre-diabetes, when blood sugar levels have already started to increase, but remain below the traditional threshold for diabetes. Returning pre-diabetes blood sugar levels to normal, the authors say, should be central in preventing diabetes.