BACKGROUND Type 2 diabetes (T2D) and impaired glucose tolerance (IGT) are associated with increased cardiovascular diseases (CVD) morbidity and mortality. T2D and IGT prevalence and their relation to other risk factors were investigated among cardiac patients. RESULTS Patients (n = 250) visiting a secondary prevention clinic at the Emergency Cardiology Centre in Tibilisi, Republic of Georgia were enrolled in the study. Information on medical and surgical histories, CVD risk factors and current medical condition was obtained using interviews, medical record abstraction, physical examination and laboratory studies. Fasting blood glucose and 2-hour post load glucose concentrations were determined. Overall 40.8% (46% among men and 33% among women) of participants had T2D while 13% had IGT (13.4 among men and 12.9 among women). Of the T2D cases, more than half were previously undiagnosed. IGT and T2D were highly associated with dyslipidaemic profiles and elevated inflammatory marker concentrations in this population. Undiagnosed T2D cases shared similar CVD risk factors as previously diagnosed T2D cases including dyslipidaemia, other metabolic syndrome components and inflammation. CONCLUSIONS Both T2D (diagnosed and undiagnosed) and IGT are prevalent; and are associated with other important CVD risk factors among cardiac patients in the Republic of Georgia. Future studies assessing associations of T2D and IGT with CVD morbidity and mortality in this population, as well as studies that assess prevalence of T2D and IGT and their relation with CVD in the general population are needed.