Severe cardiac autonomic dysfunction and diabetic neurogenic bladder significantly increase the risk of left ventricular diastolic dysfunction in adults with type 2 diabetes. A cross-sectional study of 3,440 participants examined associations between diabetic autonomic neuropathy and LVDD. The results were presented at the European Association for the Study of Diabetes (EASD) 2025 Conference. 

Cardiac autonomic function was assessed with 24-hour Holter ECG, neurogenic bladder with post-void residual volume, and gastrointestinal autonomic neuropathy via gastric emptying scintigraphy.

Severe cardiac autonomic dysfunction (SDNN <50 ms) independently increased LVDD risk (OR 1.73). Diabetic neurogenic bladder also showed an elevated risk (OR 1.36). Gastrointestinal autonomic neuropathy did not independently affect diastolic function. Women had nearly double the risk of LVDD compared to men (OR 1.99). Propensity score matching confirmed these findings.

The findings emphasize the importance of screening for severe cardiac autonomic dysfunction and neurogenic bladder and suggest that sex-specific approaches could improve identification and management of high-risk patients with type 2 diabetes.