Most of oral antidiabetics with respect to mechanism of its effect influence besides sacharide metabolism even risk factors of cardiovascular diseases and may have protective effect on function of pancreatic V-cells, may influence the inflammation and production of imflammatory cytokines, atherosclerosis and stability of atherosclerotic plaques, control of cell cycle, apoptosis and carcinogenesis. The article describes so called pleiotropic effect of thiazolindiones, metformin, acarbosis and sulfonylurea secretagogs.