OBJECTIVES: Risk-factors help identify an increasing number of people as pre-diabetic, with associated long-term problems to patients during the pre-diabetes stage; therefore, prevention of early onset of type 2 diabetes (T2D) is essential. To understand patient utilization of preventative measures, the current study examined steps taken to prevent diabetes among at-risk Brazilian patients, compared with diagnosed T2D patients. METHODS: Data were collected from the Brazil 2011 National Health and Wellness Survey, a cross-sectional survey of self-reported demographics, health outcomes, healthcare attitudes and behaviors among 12,000 adults. Risk of developing diabetes was assessed with the following question: “Has your doctor told you your blood sugar levels are high, or that you have early diabetes or are at risk for developing diabetes?” Respondents answering “yes” and not already diagnosed with diabetes were classified as pre-diabetics. Self-reported diagnosed T2D and pre-diabetics reported on what steps, if any, they took to prevent diabetes: low fat, low sodium and low sugar diet, regular exercise, and weight loss. RESULTS: Among 12,000 respondents, the prevalence of T2D and pre-diabetes in Brazil was 4.0% (n=480) and 10.7% (n=1,288), respectively. Significant differences emerged in the use of any preventative steps between T2D (77.9%) and pre-diabetic (56.7%) patients, p<0.001. Diagnosed diabetics were significantly more likely than pre-diabetics to eat a low fat (44.6% vs. 28.3%, p<0.001), low sodium (27.5% vs. 14.6%, p<0.001), or low sugar diet (65.0% vs. 42.6%, p<0.001), and to attempt weight loss (35.2% vs. 29.7%, p=0.025). No significant differences were found on regular exercise (28.1% vs. 24.7%) between the groups. CONCLUSIONS: In Brazil, 43.3% of pre-diabetic patients and 22.1% of diagnosed T2D patients took no preventative steps, with on average significantly fewer steps taken by pre-diabetics. Measures ought to be taken to build awareness and encourage lifestyle changes, especially among patients at high-risk of developing diabetes.