Cardiovascular atherosclerosis is the commonest underlying cause of death in patients with diabetes mellitus. The development of atherosclerosis is often accelerated and the outcome is worse in diabetic than non-diabetic patients. This may relate to abnormalities of platelet function, coagulation, blood pressure and lipid metabolism that are characteristic of diabetes. Management of angina in diabetes should focus on reducing symptoms and prolonging life. In both of these areas there are issues specific to the diabetic patient. The role of percutaneous and surgical approaches to coronary disease in diabetic patients continues to evolve and optimal therapy remains unclear. Herein explores the clinical management of coronary artery disease in patients with diabetes. The pathophysiological basis of stable and unstable coronary syndromes is explained and the effect of diabetes on coronary disease and its subsequent management is discussed.
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