I give you bitter pills, in a sugar coating. The pills are harmless - the poison's in the sugar. — James St. James Diabetes mellitus and coronary artery disease have been known and recognized as separate clinical entities for centuries. The original description linking together these two diseases was described by Dr. J. Seegen in 1870; however, it took several years and multiple publications to establish the high prevalence of coronary atherosclerosis in diabetic patients. A series of publications on necropsy studies in the ensuing years revealed the extent of coronary atherosclerosis in diabetic subjects, providing the evidence that acute myocardial infarction was the most frequent fatal event in these patients [1] . After the introduction of insulin in 1922, cardiovascular disease replaced diabetic coma as the leading cause of death in these patients; however, the pathogenesis of the increased predisposition to early and more aggressive cardiovascular disease was poorly understood.