This year, two prospective randomized studies aimed at the reduction of composite cardiovascular endpoints in type 2 diabetic patients. The PROactive study estimated the impact of pioglitazone in the secondary prevention. The significant reduction of the primary composite endpoint was not obtained: reduction of the relative risk (RR) of 10 % (p= 0.095). However, the secondary composite endpoint was significantly reduced RR 16 % (p = 0.027). The FIELD study also had the same objectives. The primary composite endpoint was not significantly reduced in spite of a RR of 11% while the reduction of RR was significant for the secondary composite endpoint (p = 0.035). These studies reveal the difficulties and the complexity of the secondary prevention of atherosclerosis for patients already treated with effective molecules.