The global prevalence of type 2 diabetes (T2D) is increasing, with sub-Saharan Africa most affected. Although the development of T2D differs between African and European populations, and between men and women, risk screening and guidelines for the prevention of T2D are generic. This collaboration between Sweden, Germany and South Africa enables the measurement of circulating proteins and metabolites to identify sex- and ethnic-specific biomarkers for the early prediction of T2D risk in two African cohorts (South African and Ghana) and a European (Swedish) cohort. We will also link these biomarkers to dietary patterns, which will be used to inform targeted dietary modifications for primary prevention of T2D in the different populations. The cost effectiveness of the targeted dietary modifications, as well as the perceptions among target populations regarding these early preventative strategies will be assessed in the respective countries to inform future implementation of personalised prevention strategies.