Diabetes in China part 2: prevention, challenges, and progress. The Lancet. Public health During the past 40 years, the prevalence of diabetes in China has increased from less than 1·0% in 1980 to 12·4% in 2018, an increase in line with the rapid growth of the nation's economy. To address such a burden, the Healthy China 2030 initiative and subsequent Action Plan, including a diabetes prevention and control campaign, were launched. A shift from a disease-centred approach to a health-centred approach and from treatment to prevention is the core of the Action Plan and diabetes management in China. In this Review, we discuss the challenges of diabetes prevention in China, including unhealthy lifestyle, increasing young-onset type 2 diabetes, and substantial diabetes care disparities. To address such challenges, countermeasures across different stages of diabetes prevention and targeted at different populations, are needed. Such countermeasures include primordial prevention of risk factors in the general population, primary prevention of diabetes onset in high-risk populations, and secondary prevention of cardiovascular complications for individuals with diabetes. We reflect on China's current progress, strategies, and achievements. 10.1016/S2468-2667(24)00251-2