Abstract : Type 2 diabetes represents a major medical and public health problem due to its huge heterogeneity, the alarming rise of its incidence worldwide and its associated vascular complications, which impair quality of life and reduce life expectancy. At the present time, a patient-centered approach is recommended for the management of type 2 diabetes patients. However, these recommendations are not easy to implement because we only have little objective evidences to establish individualized strategies. Following the recent introduction of new drug classes, a large number of combinations is offered to clinicians, but we do not have high quality interventional studies comparing these different therapeutic possibilities. Moreover, the response to pharmacological treatment can vary greatly from one subject to the other. Pharmacogenetics might be a useful tool to better characterize the patient. However, despite some progress, the evidence we now have is very preliminary and should not allow to improve significantly the individual management of type 2 diabetes in the near future.