Diabetic patients typically have a low compliance rate to intervention and lifestyle change. Although diabetes has been studied for years, the disease remains a leading cause of death in the United States and approaches a prevalence of 40% in certain ethnic populations. The mortality rate for NIDDM is two three times higher than the average healthy person, primarily due to cardiovascular complications. More than 10 million people in the United States alone are diagnosed with diabetes. Clearly, with health care resources dwindling, improved treatment outcomes are needed. The physiologic mechanism involved in the development of the preliminary phase of Type II diabetes or syndrome X is particularly amenable to primary and secondary prevention as well as health promotion activities. NPs provide an alternative delivery of care based on health-promotion and disease-prevention principles. NPs working in a primary care delivery model with patients at risk for diabetes have the opportunity to bring about measurable outcome differences.