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Extensive research demonstrates the effectiveness of two broad strategies to prevent or delay the onset of type 2 diabetes in adults: pharmacological therapy and structured lifestyle interventions. To date, however, high-quality preventive services have proved particularly challenging to deliver in health care settings, even when there is compelling evidence for their clinical cost-effectiveness. Conversely, resources and policies to support modest weight loss and moderate physical activity behaviors have a stronger capacity to reach vast segments of the population when offered in non-healthcare community settings. This chapter considers the current evidence base for cost-effective prevention of diabetes and explores implications and emerging research for implementing policies and programs to prevent type 2 diabetes in non-healthcare settings.

This chapter discusses the treatment options for obesity when prevention falls short. It covers the three primary treatment options available — lifestyle modification, pharmacotherapy, and surgery — from the goals of treatment to selecting the appropriate therapy for an individual. It also discusses the current evidence on the effectiveness of these treatment options in combating obesity and related co-morbid conditions.

Observational studies and clinical trials have shown that lower levels of risk factors in patients with established cardiovascular disease (CVD) can substantially reduce their risk of suffering recurrent vascular events. Efforts directed towards reducing further CV events in patients with established CVD are known as secondary prevention. This chapter reviews the epidemiological evidence for risk factor control, lifestyle changes, and medical strategies in the secondary prevention setting. Mainstays of secondary prevention include attention to blood pressure lowering, glucose control, tobacco cessation, and optimizing an individual's cholesterol using proven medical therapies, together with sound dietary and physical activity programs, and regular use of antiplatelet agents.

Chapter 3 focuses on the Tangsa, and discusses their linguistic and ethnic classification into sub-groups such as the Pangwa, their relation to the Naga and the Singpho, as well as some of their ‘traditional’ practices, their festivals, their lifestyles and their social and cultural traditions. Starting with the past, I end in the present by describing the changes that have come to their lives with their move down the hills, their conversion to Christianity and their gradual move to a ‘modern’ style of living. The last section of the chapter describes my own introduction to the Tangsa and my first reactions to the differences I noted in their lifestyles with mine.