Diabetes-related complications including cardiovascular disease, heart failure (HF), chronic kidney disease, retinopathy, and neuropathy are still a major burden to many people with type 2 diabetes. In the attempt to reduce such burden, early achievement and sustained glycaemic control have been recommended by international guidelines. Landmark studies such as the UKPDS have lent support to the importance of glycaemic control to prevent of delay microvascular complications. However, cardiovascular disease (CVD) is the principal cause of death and lowering HbA1c has only a modest effect on reducing CVD risk and mortality underlying the need for treatments with actions that go beyond glycaemic control. In addition to improvements in glycemic control and CV risk factors, CV outcomes trials (CVOTs) of SGLT2-inhibitors such as empagliflozin (EMPA-REG OUTCOME), canagliflozin (CANVAS), and dapagliflozin (DECLARE-TIMI 58) showed significant glucose-independent reductions in the risk of major adverse CV events and/or hospitalization for HF, as well as reductions in the risk of kidney disease progression, versus placebo. These CVOTs and the more recent renal outcomes study of canagliflozin (CREDENCE) support the early initiation of SGLT-2 inhibitors to potentially provide the most benefit toward glycemic control and CV and renal risk. All these results have confirmed in real world studies highlighting a peculiar beneficial effect in reducing the risk of heart failure. Even more intriguingly, recent data suggest that such an effect may be exerted even in non-diabetic individuals. Because of all this evidence, current treatment recommendations encourage early addition of SGLT-2 inhibitor therapy, not only in patients with established CVD, HF, and/or CKD but also in the general population of patients with T2D.