<International Circulation>: What is the appropriate management strategy for patients with diabetes and cardiovascular disease who are in need of revascularization?

Donald E. Cutlip ：For 1-2 vessel disease that can be approached with high success by stenting and is associated with definite ischemia， I think drug-eluting stenting is a reasonable strategy. I think for diffuse disease， especially if the proximal left anterior descending is involved， then bypass surgery is probably preferred. We must also keep in mind that， similar to patients without diabetes， medical therapy is also a reasonable initial strategy.  In my opinion， if definite large territories of ischemia are present， revascularization is a better option.  As shown in BARI-2D， however， an initial medical strategy is reasonable， but there is high rate of eventual requirement for revascularization. 

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