Objective To evaluate the early change of left ventricular systolic function in patients with type 2 diabetes mellitus (T2DM)using two-dimensional layer-specific speckle-tracking imaging. Methods The study included 60 T2DM patients without hypertension and coronary artery disease, and 60 normal controls. Global longitudinal strains (GLS) and global circumferential strains (GCS) of three myocardial layers (endocardial, mid-myocardial andepicardial) and three segments (basal, middle and apex) were measured usinglayer-specific speckle-tracking imaging.Globalradial strains (GRS) of three segments were also assessed. Results Among all the subjects, GLS and GCS decreased gradually from the endocardiallayerto the epicardial layer but increased gradually from the basal segment to the apex segment (all p<0.01).Moreover, in both groups,GRS were lower in the apex segment than in the basal segment(all p<0.05). Compared with control subjects, patients with T2DM had lower GLS of the three myocardial layers, the basal segment and the middle segment (all p<0.05). Patients with T2DM tend to have lower GLS of the apex segment thancontrol subjects (p=0.058). The GCS of the middle segment and the GRS of the apex segment were higher in patients with T2DM than in control subjects (p=0.014 and p=0.006, respectively). Conclusion Patients with T2DM have had left ventricular systolic dysfunction prior to decreased ejection fraction. The long-axis global systolic function and the middle-apex segments of the left ventricle may damage more easily.