The article presents data on the prevalence of diabetes and prediabetes; the high compatibility of diabetes mellitus and cardiovascular pathology; high mortality among patients with diabetes mellitus and coronary heart disease, in the presence of both acute and chronic cardiovascular complications; on the important role of glucose- and lipotoxicity in the progression of carbohydrate metabolism from prediabetes to type 2 diabetes mellitus, the role of hyperglycemia in the deve-lopment of insulin resistance, atherosclerosis, hypertension, liver, kidney, endothelial dysfunction, the role of hyper- and hypoglycemia in the development of acute vascular complications – myocardial infarction, stroke, gangrene of the lower extremities; on the protective role of adiponectin – a predictor of type 2 diabetes mellitus, on the importance of glycemic control for the timely detection of early disorders of carbohydrate metabolism – impaired glucose tolerance and impaired fasting glucose; on the role of metformin in the prevention of progression of prediabetes to type 2 diabetes and cardiac pathology; on the gluco- and cardioprotective role of modern sugar-lowering drugs.