The European Forum for Primary Care (EFPC) held a consultation process among European experts and identified the elements considered to be essential for high quality diabetes care. More attention should go to diabetes prevention. An interdisciplinary team should provide comprehensive shared care, focused on patient empowerment. The further development of ICT is important to facilitate communication and quality monitoring. The EFPC argues the case for a primary care-centred approach to ensure equity and cost-effectiveness. But this is only possible with a strong primary care infrastructure. In many European countries important investments are needed to strengthen primary care.