Evaluation of the Functional Impact of Coronary Stenoses in Diabetics by Spectral CT

Inclusion Criteria: * Aged man ≥50 years old or woman aged ≥55 years old, (age difference justified for established menopause which increases the CV risk and to avoid the risk of CT scan during pregnancy) * Diabetic (type 1 or type 2 or type 3): * Asymptomatic, falling within the scope of screening for silent myocardial ischemia and having a CAC \> 300 AU or * Symptomatic on the coronary level, within the framework of the evaluation of symptomatic coronary insufficiency with positive myocardial scintigraphy. * Patient having agreed to participate in the study and signed a written informed consent * Patient affiliated to a social security scheme or similar Exclusion Criteria: Drug intolerance (adenosine, and/or contrast product used (Iomeron)) Related to iodine injection: * History of major immediate or delayed skin reaction + hypersensitivity to the active substance or to any of the excipients * Renal failure with GFR \< 45 ml/min - * Known autonomic goiter with risk of thyrotoxicosis * No suspension of the biguanide the same day of the examination (and resumed 48 hours later) Linked to the injection of adenosine and regadenoson (Cf SPC Adenoscan combination with dipyridamole) * 2nd or 3rd degree BAV not fitted, sinus dysfunction not fitted, * Long QT syndrome, * Decompensated heart failure, * Unstable angina / Acute coronary syndrome / ATCD IDM less than a year old * BP \> 1800 mmHg \< 100 mmHg * Known stenosis of the common trunk (left), * Tight heart valve stenosis. * Uncorrected hypovolemia, * Chronic obstructive pulmonary disease with clinical bronchospasm (e.g. bronchial asthma) * Comitiality * No suspension of dipyridamole (during the 48 hours before the examination) * Severe hypotension * Consumption of coffee, tobacco, tea, cola, banana, chocolate consumed before the examination (usual instructions in the event of myocardial stress protocol by adenosine agonist during the scintigraphy) * Contraindication to adenosine: severe hypotension Related to scanner performance * patient unable to maintain apnea. * Calcium score \> 500 on the common trunk * Temporary suspension of bradycardia or anti-anginal on the day of the examination (beta blocker, calcium channel blocker) not carried out. Related to the patient's context * Person unable to express their consent. * Patient under guardianship, curatorship or safeguard of justice