Background: Diabetes accelerates the natural process of atherosclerosis and is a predictor for progression of atherosclerotic lesions. To improve clinical outcomes, noninvasive imaging modalities have been proposed to measure and monitor atherosclerosis. Recently, it has been shown that the color M-mode-derived propagation velocity of the descending thoracic aorta (aortic velocity propagation [AVP]) was associated with coronary and carotid atherosclerosis. Methods: Carotid intima-media thickness (CIMT) and AVP were measured in 72 patients with newly diagnosed type 2 diabetes and 44 healthy people. Individuals who had previously used oral hypoglycemic agents or insulin treatment or had a history of hyperlipidemia, cigarette smoking, hypertension, and cardiovascular disease were excluded from this study. Results: Compared with control group, patients with type 2 diabetes had significantly lower AVP (39.9 +/- 6.5 vs. 58.4 +/- 6.7 cm/sec, P < 0.001) and higher CIMT (1.1 +/- 0.1 vs. 0.95 +/- 0.12 mm, P < 0.001) measurements. There were significant correlations between AVP and CIMT (r = -0.835, P < 0.001), AVP and fasting plasma glucose (r = -0.796, P < 0.001)), AVP and HbA1 c (r = -0918 P < 0.001). Conclusions: Diabetes mellitus may be associated with subclinical atherosclerosis assessed by measurement of AVP and CIMT. These simple methods might improve patient selection for primary prevention atherosclerotic progression.