[Coronary disease and type 2 diabetes]

Coronary heart disease is the leading cause of premature deaths in type 2 diabetic patients. Atypical in its clinical presentation or silent coronary heart disease in this population is to be detected early in those patients at high risk of cardiovascular disease. Males with peripheral artery disease, albuminuria and those with (or) the combination of tobacco use, hypertension and dyslipidemias. Exercise test is the non-invasive investigation to be used as a first line examination. A coronary angiography is to be performed in the patients with a positive exercise test. A significant stenosis of the left main coronary artery or a triple vessel disease, common conditions in diabetic patients, should lead to myocardial revascularisation which reduces cardiovascular mortality and morbidity. The diagnosis of coronary heart disease in type 2 diabetic patients, should induce in all cases a medical treatment including cardiological and metabolic therapies, unfortunately very poorly performed in too many patients.