This study examines the link between hyperglycaemia and micro-and macro-vascular disease in diabetes. The authors review clinical, biochemical and epidemiological evidence that high levels of blood glucose produce metabolic and biochemical alterations in vascular walls. These alterations in turn lead to abnormalities in vascular structure and function. Although there are differences in the pathogenesis of these types of vascular diseases, the text emphasizes the common effects of hyperglycaemia on vascular metabolism, function and disease. The book is based on a symposium of the American Physiological Society.