Diabetes mellitus is emerging as a global health challenge and according to World Health Organization around 366 million people in the world will be affected from diabetes by the year 2030. Diabetes mellitus, though a primary disease of carbohydrate metabolism due to deficient/absences of insulin, has propensity towards vascular endothelial dysfunction resulting into microangiopathy & macroangiopathy and is the leading cause of the death in the world. This research work has established that the uncontrolled diabetics have higher cardiovascular risk, endothelial dysfunction markers, inflammatory and proatherogenic cytokines. Further, the oral antidiabetic drugs like thiazolidinedione can reduce the endothelial dysfunction markers and also could be lipid friendly due to its PPAR gamma activity. However they have propensity to increase angiogenesis which have beneficial impact on coronary revascularization with some reservations on proliferative retinopathy and diabetic neuropathy & nephropathy. This book reveals the complicated interaction of intercellular communication causative for increased cardiovascular complications in diabetics.