Diastolic dysfunction and diabetes: the DIADAD study-a retrospective cohort study from Liverpool
Laila Wali1, Mohammad Adeeb Abbara1, Sowmya Ekhelikar1
1Department of Cardiology, Royal Liverpool University Hospital, Mount Vernon St, Liverpool L7 8YE, United Kingdom.
Postgraduate Medical Journal
|June 24, 2026
Summary
Type 2 diabetes mellitus (T2DM) significantly increases the risk of diastolic dysfunction, an early sign of heart failure with preserved ejection fraction (HFpEF). Advancing age also elevates this risk, highlighting the need for cardiovascular assessment in diabetic patients.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Diastolic dysfunction is a key early indicator of heart failure with preserved ejection fraction (HFpEF).
- Type 2 diabetes mellitus (T2DM) is linked to increased risk of HFpEF hospitalization and mortality.
Purpose of the Study:
- To investigate the association between diastolic dysfunction and T2DM in Liverpool adults.
- To account for the influence of age and sex on this association.
Main Methods:
- Retrospective review of 493 patient records.
- Assessment of diastolic function using echocardiography based on 2016 ASE/EACVI guidelines.
- Data extraction on diabetes status, age, and sex.
Main Results:
- Diastolic dysfunction prevalence was higher in T2DM patients (71.42%) versus non-diabetics (43.98%).
- T2DM increased odds of diastolic dysfunction by 2.64 times and higher dysfunction grade by 2.56 times.
- Age ≥65 years increased odds of diastolic dysfunction by 4.65 times; no significant gender difference was observed.
Conclusions:
- A significant association exists between T2DM, advanced age, and diastolic dysfunction.
- Findings suggest potential for antidiabetic therapies in HFpEF prevention.
- Consideration of incorporating T2DM into risk scores like H₂FPEF for improved stratification is proposed.
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