Many of the major interventions that will impact on diabetes incidence operate at the policy level. In order to develop sustainable understanding of what is (and what is not) effective at this level there needs to be a greater emphasis on ‘evidence-based policy making’, a development analogous to the change in approach in clinical practice. The production of information about policy effectiveness needs a change in culture among policy makers to embrace the notion of evaluation, including, where possible, the introduction of not only observational approaches but also more experimental designs.

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