The goal of Type 2 diabetes management is to prevent and delay diabetes-related micro- and macro-vascular complications. Unfortunately, Type 2 diabetes may remain undiagnosed for years before presentation, allowing the onset of diabetes-related complications to occur even before diabetes diagnosis. Then there is the heterogeneity of Type 2 diabetes – there are thought to be subtypes within Type 2 diabetes which have different disease progression rates and risk of complications. Additionally, there is the present-day concept that the concept of Type 2 diabetes as a coronary heart risk equivalent is overly simplistic as not all patients with diabetes are at the same cardiovascular risk. Instead, individual patients will need to be risk-stratified for appropriate interventions. Despite these conundrums, protocols should be in place for early and regular complication screening, together with proactive and holistic management of diabetes mellitus. This article seeks to remind readers of what is necessary.