Prevalence and Determinants of Subclinical Cardiovascular Dysfunction in Adults With Type 2 Diabetes Mellitus

Inclusion Criteria: * Participant is willing and able to give informed consent for participation in the study. * Male or Female, aged ≥18 and ≤75 years. * Diagnosed with Stable type 2 diabetes (determined by: i) formal diagnosis in GP case records, ii) a record of diagnostic oral glucose tolerance test OR glycated haemoglobin level ≥6.5%). Exclusion Criteria: * Angina pectoris or limiting dyspnoea (\>NYHA II), * Major atherosclerotic disease: Symptomatic CAD, history of myocardial infarction, previous revascularisation, stroke/transient ischaemic attack or symptomatic peripheral vascular disease. * Atrial fibrillation or flutter. * Moderate or severe valvular heart disease. * History of heart failure or cardiomyopathy. * Type 1 diabetes mellitus (T1DM). * Low fasting C-peptide levels suggestive of adult-onset T1DM. * Stage III-V renal disease (estimated glomerular filtration rate ≤30ml/min/1.73m2). * Absolute contraindications to CMR. Importantly, patients with subclinical CAD, and other common comorbidities such as obesity and hypertension, will not be excluded from this study. This will enable us to evaluate the contribution of CAD to myocardial dysfunction in diabetes and ensures our study group is representative of the general population with diabetes. Similarly, as mild dyspnoea is extremely common and non-specific participants with mild dyspnoea will be included.