There has been an alarming increase in the prevalence of diabetes over the last decade. Efforts to understand the pathophysiology and prevention have largely been directed at lifestyle and genetics. However, there is a growing body of evidence for the role of environmental pollutants, especially pesticides in the etiology of diabetes and metabolic syndrome. There seems to be an association between organophosphate pesticide exposure and hyperglycemia through a wide variety of molecular mechanisms. Our interest on this issue was sparked by anecdotal evidence presented by an increasing number of farmers in our area with diabetes and no obvious risk factors. We are therefore doing a larger study of 1000 partcipants from a farming population looking at the association between categories of pesticide exposure, urinary pesticide levels and prevalent diabetes. We are proud to collaborate with Indian Institute of Technology, Madras in this project.