The traditional 'stepwise approach' to diabetes management is increasingly considered inadequate for many individuals with type 2 diabetes mellitus. Uncontrolled hyperglycaemia places patients at risk of serious complications. The recent United Nations Resolution on diabetes has recognised this, emphasising the severe risks posed by the condition and calling on nations to improve prevention, treatment and care of diabetes. Expert groups such as the Global Partnership for Effective Diabetes Management, as well as treatment guidelines such as those of the Canadian Diabetes Association and the Western Pacific Region of the International Diabetes Federation, are now recommending early, intensive intervention to lower blood glucose levels to target levels as quickly as possible. This intervention will improve long-term outcomes and deliver a better quality of care for people living with diabetes. In this article, we review case studies from around the world showing how this strategy is being implemented.