Diabetes has become a chronic disease that poses a serious health risk. More than 90% of adult diabetics are type 2 diabetics, and cardiovascular complications are the main cause of disability and death in type 2 diabetics, among whom patients eventually die from coronary heart disease. Therefore, comprehensive treatment of diabetic patients and reduction of the development of cardiovascular disease are of great importance to improve the quality of life and prolong life expectancy. The following is an introduction to the characteristics of diabetes combined with coronary heart disease and how to screen and prevent it for diabetic patients. The risk of coronary heart disease is significantly higher in diabetic patients than in non-diabetic patients, with a two- to four-fold increase over the latter. Why are diabetic patients more likely to develop coronary heart disease? Simply put, long-term hyperglycemia, dyslipidemia, hypertension and insulin resistance lead to coronary atherosclerosis. At the microscopic cellular level, diabetes alters the function of a variety of cells, including endothelial cells, smooth muscle cells and platelet cells, which can lead to coronary atherosclerosis and intravascular plaque formation. Moreover, the coronary artery lesions in patients with diabetes mellitus with coronary artery disease are more serious, as evidenced by a wider range of lesions, often involving multiple vessels, each with diffuse multiple involvement; the coronary arteries are often severely stenosed, and the longer the duration of diabetes mellitus, the greater the degree of stenosis. Although coronary artery lesions are severe in patients with diabetes mellitus with coronary artery disease, diabetic patients often do not have typical coronary angina manifestations because of the frequent combination of neuropathy and diminished pain sensation, but more often see asymptomatic myocardial ischemia, myocardial infarction without signs, and even sudden death, which poses a great threat to life. Therefore, diabetic patients should be alert to coronary heart disease that occurs and progresses unknowingly, to achieve early prevention, early diagnosis and reasonable treatment. How to know if a diabetic patient has coronary heart disease at an early stage If there are bouts of chest tightness, chest pain and other discomforts, you should go to the hospital and have an electrocardiogram and other examinations, and if necessary, a plate exercise test can be performed according to the patient’s age and physical condition. Exercise increases the load on the heart and the ECG may show ischemic changes in the heart muscle. Radionuclide examination can determine the site and extent of myocardial ischemia and myocardial infarction according to myocardial imaging. Coronary CT imaging, which has been widely carried out in Anzhen Hospital in recent years, can visually display the morphological changes of coronary arteries, such as information on alignment, stenosis, blockage, calcification, etc. It is a more ideal simple and non-invasive examination. However, the most reliable method for clinical diagnosis of coronary artery disease and determination of the location and severity of coronary lesions is still coronary angiography. This is an invasive cardiovascular imaging method in which a catheter is inserted through an arterial puncture into the opening of the coronary artery and contrast is injected, thus showing the course and lesions of the coronary arteries. As mentioned earlier, asymptomatic myocardial ischemia is often seen in diabetic patients, so patients should visit the hospital regularly for electrocardiograms and other tests to detect the lesions in time. How to prevent and treat coronary heart disease in diabetic patients It is now believed that diabetes is equivalent to coronary heart disease, that is, the risk of myocardial infarction in diabetic patients is the same as the risk of myocardial infarction again in patients with coronary heart disease, and diabetes itself is a risk factor for coronary heart disease. Diabetic patients usually also have a variety of metabolic abnormalities, in addition to hyperglycemia, accompanied by dyslipidemia, hypertension, hyperuricemia, and hypercoagulable blood, which are all risk factors for coronary heart disease, and these risk factors have a superimposed effect, so that the ultimate consequence for the patient is a serious cardiovascular event, rather than just a manifestation of the various existing independent diseases themselves. In patients who are obese or overweight, they are more likely to have a combination of these metabolic disorders, clinically referred to as the “metabolic syndrome”, the common basis for which is insulin resistance. We have analyzed the characteristics of patients with diabetes combined with coronary heart disease and found that the degree of insulin resistance is closely related to the degree of coronary artery stenosis. Moreover, the incidence of myocardial infarction is higher in patients with metabolic syndrome than in other individuals. Therefore, diabetic patients should be treated comprehensively to correct these metabolic disorders in order to prevent or delay the occurrence and development of coronary heart disease. Patients should first adopt a healthy lifestyle, including quitting smoking and limiting alcohol, a low-fat diet, moderate exercise, and maintaining an ideal body weight. They should take reasonable medications under the guidance of doctors to keep fasting and postprandial blood glucose and blood glucose at any time well controlled, blood pressure and blood lipids at target values, and take anti-platelet agents to improve hypercoagulability. Patients who already have coronary artery disease should be treated more actively to reduce the occurrence of serious cardiovascular events such as myocardial infarction and heart failure.