The markedly increased peri-interventional risk (PCI and CABG) in patients with type-2 diabetes mellitus may be reduced by adjusting blood glucose values to a near-normal level. This adjustment should be realized acutely by glucose-insulin-potassium infusions. In long-term therapy, the target value should be achieved independent of the pharmacological principle of blood glucose reduction. Among the available oral antidiabetic agents, metformin, acarbose and glitazones seem to be cardioprotective via pleotropic effects. Given an optimal stent implantation and administration of GP IIb/IIIa inhibitors during coronary interventions, results are similar to those of non-diabetics.