Prevalence of diabetes mellitus (DM) is progressively increasing, contributing to a parallel increase in cardiovascular morbidity and mortality, and more than doubling the incidence of sudden cardiac death (SCD). Certain electrocardiographic (ECG) characteristics, such as alternans of the T wave (TWA), heart rate variability (HRV) and dispersion of the QT interval, have been found to be predictive of the risk of SCD. This review focuses on ECG changes that could be found in diabetics and their potential implication for SCD risk.