Objective To investigate the changes of left atrial (LA) structure and function using two-dimentional ultrasound speckle-tracking imaging (2D-STI) in patients with diabetes. Methods 25 patients who suffer from pure diabetes without any heart disease and 30 patients with diabetic cardiomyopathy(DCM), 20 cases of healthy persons were included. All subjects were examined with 2D-STI to obstain the apical four chmber left atrium strain and strain rate curve image. Systolic strain and stain rate(Ss, s-SR), early diastolic stain rate(e-SR) and late diastolic strain rate(a-SR) were measured. Left atrial maximum volume obtained using Simpson. Independent - Sam- ples t Test and Analysis of Variance were used to perform the date analysis. Result Compared with the control group Ss, s-SR and e-SR decreased in diabetes and DCM, and the rection of DCM were more obvious. There was no significant different in a-SR, but different result appear where comparing diabetes group. Conclusions LA reservoir and conduit function was impaired in patients with diabetes，booster pump function were decompensated in DCM. 2D-STI can effectively assess the LA function in patients with diabetes.