The purpose of type 2 diabetes treatment is to reduce the risk of diabetic complications and, as a result, improve the quality and, possibly, quantity of life. This requires control of blood glucose levels and cardiovascular risk factor management in a patient-centred approach. Careful consideration of patient factors and preferences helps the process of individualising treatment strategies and goals. With respect to medication management, the Dutch College of General Practitioners (NHG) recently updated the practice guideline on how to reach these goals. Although this guideline promotes individualised glycaemic targets for patients based on comorbidities, propensity for hypoglycaemia, and capacity to carry out the treatment plan, a more profound shift seems necessary. Based on recent trials, optimal treatment should target specific complications and inherent risks besides glycaemic targets. Patients at high risk for cardiovascular disease may benefit from treatment with drugs that lower this risk.