We investigated whether cumulative fasting glucose (FG) and insulin resistance (IR) over 20 years are associated with midlife cardiac dysfunction in young adults with or without type 2 diabetes (T2D)/prediabetes. We included young adults with T2D/prediabetes (N = 279) and matched euglycemic individuals (N = 514) who had repeated measures of fasting glucose (FG) and insulin resistance (IR) and echocardiography assessment from the Coronary Artery Risk Development in Young Adults study (CARDIA). We found that cumulative hyperglycemia is associated with midlife diastolic dysfunction in patients with early-onset T2D, and sustained IR negatively affects systolic and diastolic function regardless of T2D status.

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