Background: Type 2 diabetes mellitus (DM) is an established risk factor for cardiovascular events and the development of congestive heart failure (HF). Diastolic dysfunction is considered a precursor of HF and may be diagnosed non-invasively by echocardiography. Diastolic dysfunction is common in well-controlled type 2 diabetic patients without clinically detectable heart disease. LV diastolic dysfunction represents the earliest preclinical dysfunction and that it can progress to asymptomatic HF. Aim of the work: Is to evaluate if diastolic dysfunction in diabetic patients is due to silent ischemia. Patients and methods: This study included 80 asymptomatic patients with type 2 DM. echocardiophy was done to all patients to assess systolic and diastolic functions. Exercise ECG was done to all patients to detect IHD. Coronary angiography was done to patients with positive exercise ECG test. Results: The incidence of diastolic dysfunction was 75%, among them, impaired relaxation was d with stress exercise ECG. Patients with normal diastolic function had negative stress exercise test, while those with diastolic dysfunction, 12 patients had positive exercise stress ECG (40%) and 18 patents had negative exercise stress ECG (60%).