India is a global leader in diabetes, currently with second largest pool of diabetes in the world. Asian Indian phenotype is uniquely predisposed to develop type 2 diabetes because of strong familial aggregation as well lifestyle factors of imprudent diet and sedentary physical habit. The typical Asian Indian phenotype is the "thin-fat Indian" which means that Asian Indians have higher body fat composition and lesser muscle mass (sarcopenia) than the white or African counterparts. Aggressive screening and treatment strategies are advocated in this high-risk diabetic race. Prevention is the key for diabetes in Indians, and simple prevention themes like "Eat less, eat on time, eat right, walk more, sleep well, and smile" are needed.