Which condition typically leads to erroneous high ankle pressures in diabetic patients?

The condition that typically leads to erroneous high ankle pressures in diabetic patients is arterial calcification. In diabetic individuals, calcification of the arterial walls can occur, leading to what's known as "medial calcific sclerosis." This condition causes the arteries, particularly the tibial arteries in the lower extremities, to become stiffer and less compliant.

When performing ankle-brachial index (ABI) measurements, the presence of calcified arteries can artificially inflate the ankle blood pressure readings. This happens because the stiffened arteries cannot properly accommodate the pulsatile flow of blood, resulting in recorded pressures that are higher than they actually should be. This misrepresentation can lead to a misleading assessment of the vascular status of the patient, potentially masking underlying peripheral arterial disease.

In contrast, while peripheral arterial disease can lead to reduced ankle pressures, it does not typically increase them. Venous reflux affects venous circulation, not arterial pressures, and the overall control of diabetes mellitus relates to glucose management rather than directly influencing ankle pressures in this context. Thus, arterial calcification is the correct condition associated with erroneous high ankle pressure readings in diabetic patients.