This study assessed changes in clinical measures and proportions of patients with type 2 diabetes from different ethnic groups achieving guideline targets within a primary care diabetes annual review programme in New Zealand. A total of 7782 patients had data recorded at baseline in 2002–2003 and at follow-up two years later. A large proportion of Māori (47%) and Pacific (69%) patients had poor glycaemic control at baseline and only small improvements were made over the two years. In contrast, all ethnic groups experienced significant improvements in blood pressure and lipid management at two-year follow-up, at which time over 75% of Māori and Pacific patients received appropriate treatment with antihypertensive and lipid-lowering medication and many of the ethnic disparities in risk factors for complications were reduced.