The incidence rate of diabetes has increased dramatically in recent years, becoming another major disease next to cardiovascular and cerebrovascular diseases and cancer, and seriously endangering human health. Diabetic heart disease is the most serious in diabetes, with extremely high mortality. Diabetes affects the heart in three ways:coronary artery disease, diabetic cardiomyopathy, and cardiac autonomic neuropathy. Different types of diabetes have different incidence. The pathogenesis of the three types of diabetic heart disease has something in common, but the means of screening and treatment are different. This review integrates the latest developments related to the mechanism, clinical screening and potential therapeutic approaches of diabetic heart disease.