Diabetes mellitus is an established risk factor for cardiovascular disease (CVD). Coronary artery disease accounts for 75% of all deaths in patients with diabetes mellitus and approximately 20–25% of all patients with acute coronary syndromes (ACS)-UA/NSTEMI (unstable angina/non-ST-elevation myocardial infarction) have diabetes. Low-molecular-weight heparin has a pivotal role in the management of diabetic patients with ACS. Low-molecular-weight heparin (LMWH) chains that are fewer than 18 saccharide units retain their ability to inactivate factor Xa but not thrombin. Therefore, LMWHs are relatively more potent in facilitating inhibition of factor Xa than in the inactivation of thrombin. The efficacy and safety has been well-established in randomized clinical trials with a sizeable diabetic population.