It is a well-established fact that patients with diabetes mellitus are at high risk of cardiovascular and renal complications in the course of their lifetime. Much effort has been invested in understanding the pathobiology of this as well as in developing an effective strategy to reduce the morbidity and mortality associated with it. Metabolic control together with mitigating other known risk factors for the cardiovascular and renal disease has been the basis of improving the outcomes of all patients with diabetes. Ongoing scientific discoveries continue to provide physicians and patients with better means of treatment over the years. Each is a step forward, and with the addition of new classes of therapeutics, we will need to reconstruct the management pathway that is best for each patient given their risk profiles and characteristics.