Currently there are at least 75 FDA-approved drugs (from 12 different drug classes) indicated for the treatment of type 2 diabetes.3 Unfortunately, while many of these drugs are able to help a person manage their hyperglycemia, none are approved for the prevention of the disease and none appear to reverse the pathophysiology, allowing for the “remission” of type 2 diabetes (i.e., maintaining adequate blood glucose control in the absence of pharmaceutical intervention). On the other hand, lifestyle therapies (e.g., diet, weight loss, physical activity, etc.) have been shown to prevent the progression from pre-diabetes to type 2 diabetes, as well as allow many long-standing type 2 diabetic subjects to maintain adequate blood glucose and HbA1c levels in the absence of pharmaceutical therapies. This monograph summarizes the unique pathophysiological characteristics of this “disease,” suggesting the therapeutic strategies directed toward type 2 diabetes should be less focused on managing glucose levels and more toward a comprehensive strategy of preserving the underlying metabolic reserves that maintain glucose homeostasis through optimal insulin sensitivity and pancreatic beta cell function. Not surprisingly, the therapies that best accomplish this are those closest to the root causes of this global epidemic: lifestyle, diet, physical activity and insulin-sensitizing nutrients.