Different lines of evidence indicate that low birth weight and insufficient intrauterine nutrition may represent significant risk factors for the development of late onset non-insulin dependent diabetes mellitus (NIDDM). The evidence includes epidemiological studies, animal studies and metabolic studies of non-diabetic subjects with low birth weight. Insufficient intrauterine nutrition may induce a variety of abnormalities of metabolism in different tissues including muscle, liver, pancreas and adipose tissue; which can all in turn be related to known defects of glucose metabolism involved in the development of hyperglycaemia in NIDDM. Future studies should address the important question as to which roles genetics versus intrauterine and postnatal factors play in the etiology of late onset NIDDM in the general population. This may have important implications for which initiatives that should be applied to prevent NIDDM.