The diabetic population is at high risk for development of cardiovascular disease (CVD), cerebrovascular disease, and peripheral vascular disease. Approximately 80% of these patients die from a thrombotic cause, with CVD complications being involved in 75% of those. The mechanisms involved in the development of coronary artery disease (CAD) in the diabetic population are multifactorial, including hyperglycemia, hyperlipidemia, hypertension, and insulin resistance, ultimately leading to endothelial dysfunction and accelerated atherogenesis. Thus, diabetes has become a CAD risk equivalent. Early and aggressive intervention in treating risk factors may reduce the risk of developing diabetes and may prevent CVD in patients with established diabetes.