Type 2 diabetes (in which the body can still make insulin) can often be remedied, at least for a while, with changes in diet and exercise. Diabetes is a major risk factor for heart disease, but like most cardiologists, I leave medications relating to diabetes to family doctors or endocrinologists. Up to now, that has been an easy decision, because the only diabetic medication proven to help prevent heart disease has been metformin, a pill that has been around for many years. It is generic, cheap, and lowers blood sugar. Unfortunately, it is not always effective, and some people just cannot take it because of gastrointestinal issues. Other medicines, such as glyburide and even insulin, may help lower blood sugar, but they do not prevent heart problems.