This systematic review was undertaken to synthesize the cost-effectiveness of interventions recommended by the American Diabetes Association (ADA) to prevent and control diabetes. A total of 56 studies from 20 countries were included in the analyses. Almost all ADA-recommended interventions for preventing or treating diabetes and its complications were cost-effective. Moreover, intensive lifestyle interventions to prevent type 2 diabetes in individuals with impaired glucose tolerance compared with standard lifestyle recommendations were considered the strongest in the category very cost-effective. It is important to keep in mind that cost-effectiveness is only one aspect of the economic evaluation of diabetes interventions. However, this study showed that the majority of the recommended diabetes interventions provides both health and economic benefits.