The recognition of the importance of overweigh / obesity and metabolic syndrome as leading risk factor for diabetes and cardiovascular (CV) complications has greatly increased within last decades. Endothelial dysfunction mediating the diabetic complications associates with several important mechanisms, one of which is secretion of extracellular microparticles (MPs) by activated or apoptotic endothelial cells. MPs coordinate wide spectrum biological processes, i.e. angiogenesis, neovascularization, cell growth / differentiation, proliferation, coagulation, and they are involved in the epigenetic regulation of post-processing that is essential for phenotype modification, tissue repair, cell death, malignancy, and immunity. The commentary is discussed the role of impaired balance between number of both 
immune subsets of endothelial MPs in CV events development among dysmetabolic subjects. It has revealed that increased numbers of apoptotic MPs, as well as decreased numbers of MPs derived from activated endothelial cells aggravate endothelial damage and contribute to the continuously deteriorating endothelial damage leading to diabetes-related complications.