Complications of macrovascular disease are responsible for 50% of the deaths in patients with type 2 diabetes mellitus (DM), 27% of the deaths in patients with type 1 diabetes for 35 years or less, and 67% of the deaths in patients with type 1 diabetes for 40 years or more (1,2). The rapid progression of macroangiopathy in patients with type 2 diabetes may reflect diverse phenomena; some intrinsic to the vessel wall; angiopathic factors such as elevated homocysteine and hyperlipidemia; deleterious effects of dysinsulinemia; and excessive or persistent microthrombi with consequent acceleration of vasculopathy secondary to clot-associated mitogens (3,4). As a result of these phenomena, cardiovascular mortality is as high as 15 % in the 10 years after the diagnosis of DM becomes established (5). Because more than 90% of patients with diabetes have type 2 diabetes and because macrovascular disease is the cause of death in most patients with type 2 as opposed to type 1 (insulinopenic) diabetes, type 2 diabetes will be the focus of this chapter. In addition to coronary artery disease (CAD), patients with type 2 diabetes have a high prevalence and rapid progression of peripheral arterial disease (PAD), cerebral vascular disease, and complications of percutaneous coronary intervention including restenosis (6).