Carotid atherosclerotic lesions have been described more frequently in diabetic patients with microvascular disease than in uncomplicated diabetics.In this study, we investigated carotid intima-media thickness (IMT), as a marker of athersclerosis, in diabetic patients with retinopathy.The study group consisted of 40 (24 males and 16 females) normotensive non-smoking type 2 diabetic patients with normal renal function. Carotid intima-media thickness was evaluated using high-resolution B-mode ultrasonography.Diabetic retinopathy was assessed and graded using coloured fundus photography and fundus fluorescien angiography.Twenty age, sex and weight matched normal subjects were included in the study as a control group.They were all non diabetic with no significant medical disease.Carotid intima-media thickness was significantly higher in diabetic patients with retinopathy compared to the control group.Among the study group, carotid intima-media thickness was higher in patients with proliferative diabetic retinopathy (PDR) compared to those with non-proliferative diabetic retinopathy.Patients with proliferative diabetic retinopathy also showed a higher systolic blood pressure and a higher diastolic blood pressure as well.Carotid intima-media thickness showed positive correlation with diabetes duration, systolic blood pressure, diastolic blood pressure, fasting blood glucose, post prandial blood glucose, total cholesterol, triglycerides and diabetic retinopathy.No significant difference was found between males and females in any of the studied parameters.Multiple regression analysis revealed that the determinants of carotid intima-media thickness in the studied group were age, post prandial blood glucose, triglycerides and diabetic retinopathy.