Observational studies have suggested that the risk of mortality is equivalent for patients with myocardial infarction (MI) without previous diabetes and for diabetic patients without previous MI. Because vascular risk-reduction targets are based on a patient’s future risk, clinical practice guidelines recommend that the same or lower blood pressure and lipid targets be applied to diabetic patients as would be applied for secondary prevention following MI. Patients newly diagnosed with diabetes and those with first MIs enter a high-risk category for subsequent coronary events. Therefore, if diabetes were treated as a coronary artery disease risk equivalent, we would expect that both groups of patients should have similar increases in utilization of antihypertensive and lipid-lowering medications following their index events.