Type 2 diabetes is a major public health issue worldwide. It is a chronic disease that carries a significant burden for those diagnosed, and for the health services that must bear the high financial cost of treatment and management. This article explores the challenges facing patients newly diagnosed with type 2 diabetes and how those challenges are likely to affect the patient presenting in primary care. The article explores the pathophysiology of the condition, signs and symptoms, the impact of diagnosis, and how care can and should be personalised to address the needs of the individual.