Diabetes mellitus is associated with an increased risk of premature vascular disease. Vascular research is focusing on a potential role of adhesion molecules in diabetes mellitus, since classical risk factors including hyperlipidemia and hypertension do not completely account for the increased incidence of atherosclerosis in diabetes. After the expression of adhesion molecules on the cell surface, they are shed into plasma. Thus plasma concentrations of circulating adhesion molecules may be representative for endothelial activation, damage or turnover. Recently, evidence has been accumulating that increased plasma levels of adhesion molecules may predict cardiovascular disease, may be pathognomonic for diabetic microangiopathy or may even play a functional pathophysiologic role. The purpose of this article is to briefly summarise the role of (circulating) adhesion molecules in diabetes mellitus.