Background: Type 2 diabetes is a big challenge for public health. Successful concepts for the prevention of diabetes and strategies for addressing barriers and difficulties in prevention are urgently needed. Materials and methods: This article describes barriers and difficulties in the implementation of prevention initiatives and a communication model of how a successful implementation of primary prevention of diabetes could look like. A strategy for addressing barriers is introduced. Results: The authors describe different steps of a prevention programme and barriers. The central role of a prevention manager and concepts and experiences in the implementation of intervention programmes are explained. The article summarises solutions to overcome the barriers. Conclusion: Trained prevention managers can fulfil a key position in the implementation of an effective concept. Individual support, direct feedback and longer-term follow-up are key concepts.