Key MessagesPatients with diabetes mellitus more frequently have diffuse and multivessel coronary artery disease. Coronary artery bypass surgery is the preferred revascularization strategy in most patients with diabetes. Special attention should be given to optimal control of risk factors in the postrevascularization setting. a b s t r a c t Patients with diabetes mellitus (DM) are at increased risk for developing coronary artery disease. Choosing the optimal revascularization strategy, such as coronary artery bypass grafting or percutaneous coronary intervention (PCI), may be difficult in this population. A large body of evidence suggests that, for patients with DM and stable multivessel ischemic heart disease, coronary artery bypass grafting is usually superior to PCI, leading to lower rates of all-cause mortality, myocardial infarction and repeat revascularization in the long term. In patients with less complex coronary anatomy (2-or single-vessel disease, especially without involvement of the proximal left anterior descendent artery), PCI may be a viable option. Because these anatomic patterns are less frequent in patients with DM, there is less evidence to guide revascularization in these cases. Patients with DM and left main disease and those in the acute coronary syndrome setting are also underrepresented in randomized trials, and the best revascularization strategy for these patients is not clear. Once the revascularization procedure is performed, patients should be kept engaged in controlling the risk factors for progression of cardiovascular disease. Avoidance of smoking, control of cholesterol, blood pressure and glycemic levels; regular practice of physical activity of at least moderate intensity; and a balanced diet are of key importance in the postrevascularization period. In this study, we review the current literature in the management of patients with DM and coronary artery disease undergoing a revascularization procedure.Ó 2019 Canadian Diabetes Association. Mots clés : maladie cardiovasculaire pontage aortocoronarien diabète intervention coronarienne percutanée r é s u m é Les patients atteints de diabète sucré (DS) sont exposés à un risque accru de coronaropathie. Le choix d'une stratégie de revascularisation optimale telle que le pontage aortocoronarien ou l'intervention coronarienne percutanée (ICP) peut être difficile pour cette population. De nombreuses données probantes montrent que chez les patients atteints de DS et d'une cardiopathie ischémique multitronculaire stable le pontage aortocoronarien offre généralement des résultats supérieurs à l'ICP, puisqu'il entraîne une diminution des taux de mortalité toutes causes confondues et de revascularisation répétée à long terme. Chez les patients qui ont une anatomie des artères coronaires moins complexe (maladie monotronculaire ou bitronculaire, particulièrement sans la contribution de l'artère interventriculaire Can J Diabetes 44 (2020) 78e85antérieure proximale), l'ICP peut être une option viable. Comme ces anatomies sont moins fréquentes c...