Following initial expectations, raised by the results of the United Kingdom Prospective Diabetes Study, intervention studies aimed at tight glucose control did not reduce cardiovascular disease. The EMPA-REG OUTCOME, an empagliflozin intervention study in over 7,000 patients with type 2 diabetes mellitus and a history of cardiovascular disease, for the first time showed a rapid reduction in cardiovascular mortality. The diversity in global recruitment centres and level of glucose control during the intervention may limit the generalisability of these promising results in a high-risk population to generally well-controlled Dutch patients.