The vascular complications of type 2 diabetes are the principal causes of morbidity and mortality. The prevention of vascular complications is the cornerstone of diabetes management. It includes early and regular screening of cardiovascular risk factors and multifactorial interventions promoting life-style and a step-wise introduction of medical treatment, most frequently multimedication. Overall, the management of these patients implies involving them as the main actors of their disease management. We need to take into account of their beliefs and their priorieties to seek actively the causes of non compliance and beyond evidence based medicine to accompany them in choosing the interventions they are ready to invest themself.