Background Compared with non-diabetics, the prognosis in patients with diabetes after coronary stenting is poor, with a high rate of in-stent restenosis. Recent data with drug-eluting stents (DESs) have shown improved clinical outcomes in diabetic patients. We compared the impact of sirolimus-eluting stents (SESs) and paclitaxel-eluting stents (PESs) on long-term clinical outcome in diabetic patients with coronary artery disease. Methods and Results Between February 2003 and August 2004, 920 patients with 1,135 lesions underwent coronary stenting using DESs, and 334 diabetics(36.3%) with 423 lesions underwent coronary stenting using either SESs or PESs in KOMATE registry. The baseline clinical and angiographical characteristics were similar between two groups. The rate of major adverse cardiac events (MACEs) at 1 year was 6.2% in the SES group and 17% in the PES group (p=0.016). The rate of MACEs at 2 years was 7.2% in the SES group and 19.1% in the PES group (p=0.012). 3-year MACE rate was 8.1% and 19.1% (p=0.013). Conclusions Sirolimus-eluting stents may be superior to paclitaxel-eluting stents for treatment of patients with diabetes mellitus. Complete clinical follow-up data will be available for the presentation.