Type 2 Diabetes is a heterogeneous disease which harbors several different pathomechanistic entities. For a successful prevention, it is important to understand the exact pathomechanisms. Overt type 2 Diabetes usually develops through an intermediary state called prediabetes, which is also heterogeneous. This state is especially important, because it already confers a higher risk for diabetes-associated complications. Therefore, detection of prediabetes and prevention of its progression to diabetes would be desirable. In this review, we describe the phenotypes of prediabetes and type 2 diabetes. We also try to envision the first steps of a future phenotype-oriented diabetes therapy.