Background A growing body of evidence suggests that earlier diagnosis and treatment of diabetes may be benefical; however, definitive evidence is lacking. Aim To evaluate the effectiveness of an intensified multifactorial treatment on cardiovascular risk factors in patients with screen-detected type 2 diabetes. Design of study Randomised controlled trial. Setting Seventy-nine general practices in the southwestern region of the Netherlands. Method In this randomised trial, patients diagnosed with diabetes by screen-detection were assigned to intensified (n = 255) or routine treatment (n = 2,13), and followed over 1 year. Intensified treatment consisted of pharmacological treatment combined with lifestyle education to achieve haemoglobin A1c (HbA1c) Results Changes in body mass index were 0.2 (routine care) versus -1.4 kg/m(2) (intensified treatment), P Conclusion Intensified multifactorial treatment of patients with screen-detected diabetes in general practice reduces cardiovascular risk factor levels significantly without worsening HRQoL.