Diabetes and hypertension have a higher than expected comorbidity. They share common etiology, pathophysiology, and organ effects. Long-term therapeutic goals are to prevent renal failure and atherosclerosis. Management should inhibit pathophysiologic mechanisms and avoid stimulating them. The most appropriate pharmacologic agents to treat hypertension in the diabetic are ACE inhibitors, selected calcium channel blockers, alpha adrenengic blockers, and certain central alpha agonists. The only diuretics that should be used are indapamide and torsemide.