Silent myocardial ischemia in patients with diabetes mellitus during exercise tolerance testing

50 patients with diabetes were compared with 20 nondiabetic subjects, with respect to the prevalence of silent myocardial ischemia, by means of treadmill exercise testing. Results of treadmill exercise testing showed ischemia in 14 of the 50 diabetic patients [mean age 49.2 +/- 1.3] and in 2 of 20 nondiabetic control subjects [mean age 49 +/- 6] [28% VS 10%, p <0.05]. Diabetics with "positive treadmill" had a higher serum total cholesterol and lower serum high density cholesterol than "negative treadmill" diabetics. Diabetic patients with retinopathy had a higher prevalence of silent myocardial ischemia [40%] than those who did not [25%, p <0.05]. Diabetics above the age of 40 years should be screened with treadmill exercise testing