The ECG in diabetes mellitus.

Case Presentation: A 42-year-old man underwent routine blood tests that revealed a fasting blood glucose value of 105 mg/dL and hemoglobin A1c of 6.2%, resulting in a diagnosis of early type 2 diabetes mellitus. Resting 12-lead ECG showed deep S-wave in LIII and R-wave in aVL, indicating early left ventricular hypertrophy; no signs of cardiac autonomic neuropathy (CAN) were found. Stress ECG demonstrated a 2-mm depression of the ST segment. Inasmuch as this finding represents high risk for future cardiovascular disease and mortality, the patient was given strict diet restrictions, and all measures to control cardiac risk factors were advised. Throughout a 6-year follow-up, the diabetes mellitus remained well controlled, the ECG remained unchanged, and no clinical or ECG signs of neuropathy became apparent.