AIM: Carotid atherosclerosis progression is associated with a higher risk of cerebrovascular events but there is no specific data for diabetes. We assessed in a cohort of patients with diabetes the rate of atherosclerosis progression by Doppler ultrasonography and the association with cerebrovascular events. METHODS: We analyzed a retrospective cohort of 342 patients with a mean duration of diabetes of 13.6+/-10.6years. The mean delay between the first and last Doppler ultrasonography was 6.4+/-4.6years, with a mean of 3.4 examinations per person. Cerebrovascular events were noted. RESULTS: A progression of carotid atherosclerosis was observed in 20.1% of cases. No factor was significantly associated with progression. A prophylactic carotid endarterectomy was performed on 6 of the 27 patients with a stenosis \textgreater/=50%. A cerebrovascular event occurred in 1.2% of patients; none of them had carotid atherosclerosis progression. CONCLUSIONS: Carotid atherosclerosis progression in patients with diabetes is frequent but surgical treatment and cerebrovascular events are low. The benefit of a systematic follow-up of carotid atherosclerosis seems limited.