Prevention of type 2 diabetes is a major public health objective in view of the increasing prevalence of obesity in the population, the medical community and politicians to develop preventive strategies as well as effective interventions to induce remission of diabetes. Clinical studies indicate that intensive medical treatment through lifestyle adaptations and even more bariatric surgery can prevent or rather delay type 2 diabetes onset and factor remission but with a positive effect which progressively decreases with time. Duration of diabetes and weight loss are major prognostic factors. New strategies are necessary to improve both short- and long-term efficacy of diabetes prevention and remission.