Diabetes is a major public health problem affecting millions of people around the globe. In the United States alone, over 7.5 million have type 2 diabetes and an alarming 78 million adults have prediabetes and remain largely undiagnosed. This epidemic was ushered in by the ongoing epidemic of obesity and is caused in-part by sedentary life style and aging population. In this chapter we discuss the diabetes epidemic highlighting the major risk factor of diabetes, particularly type 2. We also discuss the complications of diabetes including microvascular complications as well as macrovascular disease including coronary heart disease and stroke, the major cause of morbidity and mortality in the diabetic population. Finally, we present the major therapeutic advances in diabetes including modern pharmacologic agents and their potential effects on cardiovascular risk. We also outline the recent technological advances in diabetes management including closed loop systems, artificial pancreas, stem cell therapy among other ongoing research bound to prevent and/or alleviate the effects of this ongoing epidemic.