Review The

current prevalence of diabetes and obesity is unprecedented in the United States and abroad. Based on data from 2005–2008, 25.6 million, or 11.3 % of all people in the United States ≥ 20 years of age, have diagnosed or undiagnosed diabetes [Centers for Disease Control and Prevention (CDC) 2011]. The total direct medical costs and indirect costs (disability, work loss, premature death) associated with diabetes in the United States during 2007 was $174 billion (CDC 2011). Another 35 % of people in this age category are estimated to have prediabetes, a condition where blood glucose is higher than normal but not high enough to be classified a