The prevalence of diabetes continues to increase world-wide and is a leading 
cause of morbidity, mortality, and rapidly rising health care costs. Although 
strict glucose control combined with good pharmacological and non-pharmacologic 
interventions can increase diabetic patient life span, the frequency and 
mortality of myocardial ischemia and infarction remain drastically increased in 
diabetic patients. Therefore, more effective therapeutic approaches are urgently 
needed. Over the past 15 years, cellular repair of the injured adult heart has 
become the focus of a rapidly expanding broad spectrum of pre-clinical and 
clinical research. Recent clinical trials have achieved favorable initial 
endpoints with improvements in cardiac function and clinical symptoms following 
cellular therapy. Due to the increased risk of cardiac disease, cardiac 
regeneration may be one strategy to treat patients with diabetic cardiomyopathy 
and/or myocardial infarction. However, pre-clinical studies suggest that the 
diabetic myocardium may not be a favorable environment for the transplantation 
and survival of stem cells due to altered kinetics in cellular homing, survival, 
and in situ remodeling. Therefore, unique conditions in the diabetic myocardium 
will require novel solutions in order to increase the efficiency of cellular 
repair following ischemia and/or infarction. This review briefly summarizes some 
of the recent advances in cardiac regeneration in non-diabetic conditions and 
then provides an overview of some of the issues related to diabetes that must be 
addressed in the coming years.