Endocrine impairment is more common in patients with diabetes than in general population. Both hyper- and hypothyroidism increases cardiovascular morbidity and mortality. Subclinical hypothyroidism is a risk factor for coronary hearth disease in patients younger than 65 years. In elderly is its influence questionable or even preventive and the benefit of substitution should be weighted against the risks. Treatment with glucocorticoids in a dose of 7.5 mg methylprednisolone and higher considerably increases risk of vascular impairment. Patients cured from endogenous Cushing's syndrome maintain increased cardiovascular risk factors and structural changes of vessels. Subclinical hypercortisolism seems to have little effect. Growth hormone (GH) insufficiency increases cardiovascular risks and contributes to increased mortality of these patients. To the contrary increased GH production in acromegaly effect more heart than vessels. Hypogonadism is established risk factor for ischemic accidents in men. The relationship between hypogonadism and diabetes is bidirectional. Low testosterone level increases the risk of type-2 diabetes and in diabetics is the testosterone level often low. Substitution with testosterone can not only ameliorate hypogonadal symptoms but also decrease cardiovascular risk and even improve control of diabetes.