Summary: Cardiovascular disease (CVD) is the main cause of mortality in type 2 diabetes mellitus (T2DM). Patients with T2DM have significantly higher cardiovascular risk compared to those without diabetes. The primary goal of T2DM management is to reduce diabetic complications while maintaining proper quality of life. Good metabolic control of diabetes reduces microvascular diabetic complications. Cardiovascular effect of intensive glucose control remains less certain. Diabetes management strategies traditionally focused mainly on treatment of hyperglycemia, seem not to be sufficient to decrease cardiovascular risk. Recent studies indicate that some already available antihyperglycemic drugs may improve cardiovascular outcome. Beneficial effects of new mediacations seem to be independent of glycemic control. Early use of such treatment can reduce cardiovascular risk in patients with type 2 diabetes.