Read/write is simple - use last version of ADODB library (Microsoft ActiveX Data Objects). You can execute SELECT/UPDATE/INSERT/DELETE SQL statements. SELECT statements will return Recordset objects. Instead of these statements you can manipulate Recordset object by methods (AddNew, Delete, Update).

Creating tables is more complex - you must use ADOX library (Microsoft ADO Extension for DDL and Security). Use Catalog object and its Tables collection, to which you can add new table definition, including definition of all its fields (through Columns collection).