Diabetic Cardiomyopathy Diagnosis Criteria

Diabetic cardiomyopathy primarily occurs in individuals with a significant history of diabetes, typically of a more severe and long-standing nature. In addition to the presence of diabetes, there must be clear evidence of myocardial dysfunction. This often includes abnormalities in diastolic function, which may progress to systolic dysfunction in more advanced stages. Cardiac enlargement is also commonly observed.

Early Signs of Diabetic Cardiomyopathy

Impaired diastolic function is considered the earliest detectable sign of diabetic cardiomyopathy. This condition may persist for a prolonged period before progressing to systolic dysfunction, reduced ejection fraction, and noticeable heart enlargement. Importantly, while large coronary arteries may appear normal, microvascular function is often compromised in diabetic patients.

Microvascular and Metabolic Indicators

Chronic poor glycemic control can lead to complications such as retinopathy and nephropathy. In diabetic nephropathy, renal biopsy may reveal characteristic changes consistent with diabetes-related kidney damage. Similarly, a myocardial biopsy may show microvascular abnormalities and the presence of PAS-positive glycogen deposits. These findings, along with evidence of altered cellular metabolism, support a definitive diagnosis of diabetic cardiomyopathy.