Background: Type 2 diabetes mellitus (T2DM) is associated with increased cardiovascular morbidity, including diabetic cardiomyopathy and left ventricular diastolic dysfunction (LVDD). Chronic hyperglycemia contributes to myocardial fibrosis, microvascular dysfunction, and increased myocardial stiffness, leading to impaired ventricular relaxation. LVDD often precedes symptomatic heart failure and may remain clinically silent. Early detection of subclinical cardiac dysfunction may improve cardiovascular risk stratification in patients with T2DM.

Objective: To evaluate the association between glycemic control, measured by glycated hemoglobin (HbA1c), and left ventricular diastolic dysfunction in patients with T2DM.

Methods: This cross-sectional study included 100 patients with established T2DM aged 30–70 years. Patients with uncontrolled hypertension, valvular heart disease, known coronary artery disease, or reduced ejection fraction were excluded. HbA1c levels were measured using high-performance liquid chromatography. All participants underwent transthoracic echocardiography. Diastolic function was assessed using transmitral Doppler and tissue Doppler imaging parameters including E/A ratio, E/e′ ratio, left atrial volume index (LAVI), and deceleration time (DT). Correlation between HbA1c levels and echocardiographic indices of diastolic dysfunction was analyzed.

Results: The mean age was 55.2 ± 9.6 years and 58% were male. Mean HbA1c was 8.3 ± 1.6%. LVDD was observed in 66% of patients, with Grade I dysfunction most common. HbA1c showed a significant positive correlation with E/e′ ratio (r = 0.62, p < 0.001) and LAVI, and an inverse correlation with E/A ratio (r = −0.54, p < 0.01). LVDD prevalence increased progressively with higher HbA1c, reaching 87% when HbA1c exceeded 8.5%.

Conclusion: Poor glycemic control is strongly associated with LVDD in T2DM. Echocardiographic screening in patients with elevated HbA1c may allow early detection of subclinical cardiac dysfunction and enable timely preventive interventions.

Aparnna Nair is an Internal Medicine Trainee in the United Kingdom with a strong academic interest in Endocrinology and Diabetes. She holds a Master’s in Public Health from the University of Glasgow, awarded under scholarship, and a degree in Family Medicine affiliated with the Royal College of General Practitioners (RCGP), UK. She is also an Honorary Tutor at Ulster University, Northern Ireland, where she is actively involved in undergraduate medical education. Nair has authored five publications and has presented clinical cases at national conferences across the UK. Her academic interests include diabetes-related cardiovascular complications, inpatient glycemic management, and quality improvement in metabolic disease. She is actively engaged in research and audit projects, with a focus on improving patient safety and early identification of complications in diabetes. Alongside her clinical training, she is committed to medical education and regularly contributes to teaching junior doctors and medical students. Her long-term career goal is to pursue speciality training in Endocrinology and Diabetes, combining clinical practice with research, education, and quality improvement to enhance patient outcomes.