 CANOE is a moderately sized, randomized, double-blind controlled trial to determine if Avandamet will decrease the development of diabetes in individuals at high risk for this condition. A total of 200 patients will be followed for an average follow up of 4 years range 3 - 5 years. Active treatment with Avandamet Metformin 500 mg Rosiglitazone 2 mg administered as one capsule twice daily will be compared to matched placebo. 