Metabolomic studies have shown several serum or plasma biomarkers are raised in subjects with insulin resistance and type 2 diabetes (T2D). In addition, several of these biomarkers, including various lipoprotein parameters, markers of inflammation and branched chain amino acids have been shown to be associated with new-onset T2D. A recently developed clinical Nuclear Magnetic Resonance (NMR) instrument the Vantera® Clinical Analyzer has the ability to measure these biomarkers in a single serum sample. Combining these NMRmeasured biomarkers of future diabetes risk into a single algorithm called the Diabetes Risk Index or DRI, allows better diabetes prediction than any one of the individual biomarkers. This review summarizes the data suggesting that DRI may be a simple, inexpensive way to alert patients of their heightened risk of developing diabetes before they become prediabetic, allowing time for effective lifestyle modification to theoretically prevent, not just delay, onset of the disease.