Background: Diabetes mellitus (DM) is one the strongest risk factors for cardiovascular disease and, in particular, for ischemic heart disease (IHD). The pathophysiology of myocardial ischemia in diabetic patients is complex and not fully understood. Some diabetic patients have mainly coronary stenosis obstructing blood flow to the myocardium and others present with coronary microvascular disease with an absence of plaques in the epicardial vessels. Objective: This review article aimed to study diabetes mellitus in order to reduce the high morbidity and mortality due to cardiovascular disease in diabetic patients. Methods: These databases were searched for articles published in English in 3 data bases [PubMed -Google scholarscience direct] and Boolean operators (AND, OR, NOT) had been used such as diabetes mellitus and ischemic heart disease or coronary artery disease and in peer-reviewed articles between July 1998 and April 2021. A 23-year date range was selected without language limitations, and filtered in selected data basis for the last 23 years. Documents in a language apart from English have been excluded as sources for interpretation. Papers apart from main scientific studies had been excluded (documents unavailable as total written text, conversation, conference abstract papers and dissertations). Conclusion: Diabetes mellitus, a simultaneously endocrine and metabolic disease, is an especially aggressive process leading to vascular lesions. In order to reduce the high morbidity and mortality due to cardiovascular disease in diabetic patients the goals of prevention must be maximal on non-diabetic persons who already have ischemic heart disease.