Myocardial fibrosis in type 2 diabetes is associated with functional and metabolomic parameters

•Patients with Type 2 Diabetes Mellitus are at increased risk of heart failure and adverse cardiovascular events, independent of coronary artery disease.•A significant number of patients with Type 2 Diabetes have evidence of focal or diffuse myocardial fibrosis as measured by cardiovascular magnetic resonance•Diffuse myocardial fibrosis (raised extracellular volumes) is associated with reduced exercise capacity on cardiopulmonary testing and the selected metabolites are associated the presence of diffuse myocardial fibrosis, identifying potential biomarker, mechanistic and therapeutics for further investigation.