Type 2 diabetes mellitus affects more than 7 million Americans, 1 leading annually to 2.8 million hospitalizations, 2 more than 300,000 deaths, 3 and more than $100 billion in total costs. 4 Improved glycemic control is known to slow the onset and progression of microvascular complications, but its effect on atherosclerotic cardiovascular disease has not been demonstrated conclusively. 5 , 6 In the absence of completely effective treatment, primary prevention is an attractive, though hypothetical, option. Prevention programs depend on the identification of potentially modifiable risk factors. For example, adiposity, physical inactivity, and insulin resistance, all of which were identified in epidemiologic studies as strong risk . . .