Vascular disease remains the major contributor to morbidity and mortality in the diabetic population. Conventional classification into micro- and macrovascular disease is a useful distinction for the purposes of research and debate, although several risk factors and mechanisms appear to be implicated in both patterns of disease. The results of recent intervention trials, including the Kumamoto, UKPDS 33, and Steno 2 studies, concur that tight glycemic control benefits vascular prognosis in type 2 diabetes.Hypercoagulability, oxidative stress, and endothelial dysfunction are common in diabetic patients, and an increasing body of evidence points to their role in both micro- and macrovascular disease. Research into the hemovascular properties of gliclazide has paralleled this progress in the understanding of pathophysiology, with interest focusing on the potential for this molecule to provide glycemia-independent vascular protection in the management of type 2 diabetic patients.