Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Mellitus and Its Associated Factors: A Cross-sectional Study

Introduction: Type 2 diabetes mellitus (T2DM) is associated with substantial cardiovascular morbidity, often mediated through subclinical myocardial dysfunction. Left ventricular diastolic dysfunction (LVDD) represents an early manifestation of diabetic cardiomyopathy and may precede overt heart failure. However, data on the burden and determinants of LVDD among Nepali patients with T2DM remain limited. Methods: A hospital-based cross-sectional study was conducted among 93 adult patients with T2DM attending a tertiary care center in Nepal. All participants underwent comprehensive transthoracic echocardiography using American Society of Echocardiography criteria to assess diastolic function. Demographic, clinical, and metabolic variables were recorded. Bivariate associations were evaluated using Chi-square and Mann–Whitney U tests. Multivariable binary logistic regression was performed to identify independent predictors of LVDD. Results: The median age of the study population was 56 years (interquartile range: 45-66 years), 57% were female, and the mean HbA1c was 9.35 ± 2.25%. LVDD was detected in 50 patients (53.8%). Patients with LVDD were significantly older and had higher HbA1c levels compared to those without LVDD (p < 0.001 for both). On univariate analysis, advancing age, male sex, longer duration of diabetes (≥10 years), and higher HbA1c categories were significantly associated with LVDD (p<0.05). In multivariable analysis, increasing age (AOR 1.09 per year; 95% CI 1.03–1.15; p = 0.005), higher HbA1c (AOR 1.63 per unit; 95% CI 1.24–2.13; p < 0.001), and male sex (AOR 4.05; 95% CI 1.04–15.82; p = 0.045) were the independent predictors of LVDD. Conclusion: LVDD is highly prevalent among patients with T2DM and is independently associated with advancing age, poor glycemic control, and male sex. Routine echocardiographic screening of high-risk diabetic patients may facilitate early detection and timely intervention, potentially preventing progression to overt heart failure.