The mechanism of how diabetes causes vascular injury is still unclear. The recent researches indicate that high glucose can directly influence the proliferation, apoptosis and phenotype transformation of vascular endothelial cells and smooth muscle cell, promote vascular remodeling. Fluctuating high glucose is proved to have more obvious effect on vascular remodeling than persistent high glucose. Recent data indicate that the ATP binding cassette transporter G1 would play a key role in cholesterol reverse transportation and in atherosclerosis formation. This brief overview will focus on the recent research progress concerning effect of fluctuating high glucose on vascular remodeling and the possible role of the ATP binding cassette transporter G1.