Diabetes, a global public health problem, is now emerging as a pandemic and by the year 2025, three-quarters of the world's 300 million adults with diabetes will be in non-industrialized countries and almost a third in India and China alone. There is evidence from several studies that the prevalence of Type 2 diabetes is increasing in migrant Indians. Today, the prevalence of diabetes in the urban metros of India is approaching the figures reported in the affluent migrant Indians. Environmental and lifestyle changes resulting from industrialization and migration to urban environment from rural settings may be responsible to a large extent, for this epidemic of Type 2 diabetes in Indians. Obesity, especially central obesity and increased visceral fat due to physical inactivity, and consumption of a high-calorie/high-fat and high sugar diets are major contributing factors. There is also strong evidence that Indians have a greater degree of insulin resistance and a stronger genetic predisposition to diabetes. As several of the factors associated with diabetes are potentially modifiable, this epidemic of diabetes can be curbed if proper measures are taken to increase physical activity and reduce obesity rates in adults, and most importantly, in children. In addition, strategies to achieve healthy fetal and infant growth and encouraging the use of traditional diets rich in fibre are also important steps. Such interventions should be attempted in those who are genetically predisposed to diabetes in order to tackle the explosion of, and thereby reduce the burden due to, diabetes within the Indian subcontinent.