Objective: To present results from a district-wide diabetes prevention programme involving health education for school children and the local community. Method: The model of health education that was utilized aimed to secure lifestyle changes and the identification of diabetes risk by school children (aged 9-12 years). The children acted as health messengers in their families as well as in the neighbouring community. Health education sessions were also held for school teachers, non-governmental organizations, primary health centre physicians, self-help groups and laypeople in the district. All were trained in diabetes risk assessment by using the standardized Indian diabetic risk score and were trained to estimate urine glucose. Results: Over a four-year period (2005-2009) the programme trained 8288 teachers and 119,743 schoolchildren in 679 schools and 30,915 people working in the health and development sectors. Trained school children reached out to 2.4 million people in over 500,000 families, covering 80% of the district population (3 million). The project identified 83,907 (3.5%) people as being at high risk of developing diabetes and these were counselled regarding risk reduction and lifestyle modifications. Among those identified with diabetes risk, 15,868 (19%) people were identified as having positive urine glucose. There were 10,522 (0.4%) people with known diabetes who were referred to identified diabetes care centres in the district. Conclusion: This child-to-family-based lifestyle change and health education intervention, along with community participation, offers a novel approach with substantial coverage of district populations in India.