The incidence of diabetes mellitus (DM) is increasing globally, becoming one of the most prevalent and costly chronic diseases. DM is closely linked to cardiovascular disease (CVD), which is the leading cause of morbidity and mortality in diabetic patients. Common CVD risk factors such as obesity, hypertension, and dyslipidemia are prevalent in diabetic patients, increasing their risk of cardiac events. Biological mechanisms associated with DM, such as increased oxidative stress, coagulability, endothelial dysfunction, and autonomic neuropathy, also contribute to CVD risk. Targeting these risk factors is crucial for minimizing long-term CV complications in diabetic patients. This review summarizes the relationship between DM and CVD, examines possible mechanisms of disease progression, discusses current treatment recommendations, and outlines future research directions. Key areas include glycemic control, obesity, hypertension, dyslipidemia, diabetic cardiomyopathy, and cardiovascular autonomic neuropathy. Treatment strategies focus on improving glycemic control, managing weight, lowering blood pressure, and treating dyslipidemia to reduce CV risk. Future research should explore the optimal timing and duration of glycemic control, the best treatments for cardiomyopathy and autonomic neuropathy, and the role of HDL in CV health.The incidence of diabetes mellitus (DM) is increasing globally, becoming one of the most prevalent and costly chronic diseases. DM is closely linked to cardiovascular disease (CVD), which is the leading cause of morbidity and mortality in diabetic patients. Common CVD risk factors such as obesity, hypertension, and dyslipidemia are prevalent in diabetic patients, increasing their risk of cardiac events. Biological mechanisms associated with DM, such as increased oxidative stress, coagulability, endothelial dysfunction, and autonomic neuropathy, also contribute to CVD risk. Targeting these risk factors is crucial for minimizing long-term CV complications in diabetic patients. This review summarizes the relationship between DM and CVD, examines possible mechanisms of disease progression, discusses current treatment recommendations, and outlines future research directions. Key areas include glycemic control, obesity, hypertension, dyslipidemia, diabetic cardiomyopathy, and cardiovascular autonomic neuropathy. Treatment strategies focus on improving glycemic control, managing weight, lowering blood pressure, and treating dyslipidemia to reduce CV risk. Future research should explore the optimal timing and duration of glycemic control, the best treatments for cardiomyopathy and autonomic neuropathy, and the role of HDL in CV health.