...in the Multi-Ethnic Study of Atherosclerosis, diabetes was among the risk factors that were associated with risk overestimation in a single-variable analysis.2 Since the early 2000s, the New Zealand Ministry of Health has recommended the use of cardiovascular disease risk prediction to inform preventive treatment decisions, and that recommendation resulted in an increase in screening for diabetes status. ...in 2012, only 50% of eligible adults had been screened for diabetes. ...New Zealand created a new national initiative to increase screening for diabetes in the eligible population, which replaced fasting blood glucose with non-fasting glycated haemoglobin (HbA1c) as the recommended screening test. Global diabetes prevalence is increasing from the rise in obesity, unhealthy diets, and widespread physical inactivity due in part to growing urbanisation and its impact on lifestyle factors.4 This increasing prevalence, in addition to the adoption of cardiovascular disease risk estimation by many countries that require screening for diabetes, will increase the heterogeneity of the cardiovascular disease risk profile among individuals with diabetes. Since many primary prevention guidelines from national organisations around the world consider patients with diabetes at high cardiovascular risk, these guidelines require re-examination when diabetes screening levels are high.