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Several studies have demonstrated evidence for preclinical left ventricular (LV) diastolic dysfunction in patients with diabetes mellitus (DM) independent of coronary disease or hypertension. The objectives of our study were to determine if LV diastolic dysfunction determined by tissue Doppler indexes worsens with duration of DM and to quantify severity of dysfunction as a function of DM duration. From 1996 to 2007, all Olmsted County, Minnesota, residents with DM free of heart failure who had a subsequent measurement of diastolic function using tissue Doppler echocardiography were identified. We identified a validated group of 486 patients with incident DM with a subsequent tissue Doppler echocardiographic assessment of diastolic function. There was a significant association between the ratio of early mitral velocity (E) to medial mitral annulus velocity (e′) and time from diabetes diagnosis to echocardiogram …