[Moenckeberg media sclerosis: clinical aspects in diabetic patients]

We assessed in 1662 consecutive diabetic patients systolic arm-ankle indexes by a Doppler ultrasonic method. In those patients with indexes greater than or equal to 1.3 directional Doppler sonometry and mercury strain gauge plethysmography were performed. In some instancies electronic oscillography, duplex sonography and vital microscopy were additionally done. In 4.45% of the patients functional findings of a mediasclerosis could be encountered. Location of arterial mediacalcinosis was documented by x-ray examinations. Sensitivity of none invasive methods was merely 100%, specificity ranged from 96% (Dopplersonometry) to 80% (Duplexsonometry). In 18.9% an occlusive arterial disease could additionally be found. Mediasclerosis preferentially was encountered in Type II diabetics of older age. In this group painful distal neuropathy in many instances existed mimicking claudication, retinopathy and nephropathy was as frequent as in other diabetics. Normal or elevated Doppler indexes did not exclude occlusive arterial disease whereas diabetics with mediasclerosis and ulcero-gangreneous lesions or amputations in most of the cases did not have occlusive arterial disease.