Prevalence of severe arteriosclerosis obliterans in patients with diabetes mellitus. Relation to smoking and form of therapy.

Noninvasive methods were used to determine the prevalence and severity of arteriosclerosis obliterans associated with diabetes in 674 subjects including 153 recruited as controls. A resting ankle systolic blood pressure that was less than 90% of the arm pressure indicated severe arteriosclerosis obliterans. Of the 71 subjects with severe disease, 64 (90%) had a history of smoking, which is significantly greater than the 60% overall smoking rate (p less than 0.001). In non-insulin-dependent diabetic smokers, the diet-treated subjects had 2.5 times the prevalence of severe arteriosclerosis obliterans as those treated with insulin (p = 0.01); the sulfonylurea-treated subjects had twice the prevalence of severe disease as those treated with insulin (p = 0.015).