Cardiovascular diseases are major complications of type 2 diabetes, accounting for approximately two-thirds of deaths from type 2 diabetes. The research progression of diabetic heart disease in patients with type 2 diabetes is accelerated by a wide array of pathophysiological processes such as abnormal blood glucose, dyslipidemia, insulin resistance, chronic low-grade inflammation, oxidative stress, endothelial dysfunction, vascular calcification and hypercoagulability. Diabetic cardiomyopathy is one of the most common diabetic heart diseases that can lead to cardiac dysfunction and eventually to heart failure, arrhythmia, and even sudden death. This article reviews the pathogenesis of diabetic cardiomyopathy and available and potential treatment options.