Type 2 diabetes (T2D) is a metabolic disorder characterized by high blood glucose levels and elevated risk of cardiovascular events. The progression of T2D can be delayed, or prevented, so early prediction is of high importance. More than 70 genetic loci are associated with T2D risk, raising the possibility of early identification of future cases. Results show that the benefits in discrimination by including genes in current risk models are uncertain. Improvements have been shown in reclassification but are too modest for clinical use. Given the current guidelines for T2D risk assessment and the increasing availability of genotyped individuals, we could soon be able to use genetics, not to quantify risk, but to inform clinicians on those requiring earlier observation.