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The influence of disease duration and glycemic control on cardiac function in type 1 diabetes mellitus (T1DM) patients remains controversial. There is little data on young patients in the Sub-Saharan continent. The aim of this study was to determine the effect of disease duration and glycemic control on the cardiac function of children and adolescents with diabetes using echocardiography. In this cross sectional study, 26 T1DM subjects and 33 matched controls had conventional echocardiography done. The relationship between their cardiac parameters, disease duration and glycated hemoglobin (HbA1c) level was assessed with correlation and regression analysis. Five (19.2 %) subjects had evidence of abnormal fractional shortening. There was no significant difference in systolic function between the diabetics and controls. The isovolumic relaxation time and Deceleration time were significantly prolonged in the diabetics ( P = 0.034, P = 0.001 respectively). There was a significant correlation between disease duration and end diastolic diameter (EDD) ( P = 0.000) and Left ventricular mass ( P = 0.000). Disease duration was also an independent predictor of EDD ( P = 0.007), even after adjusting for age, body mass index and mean arterial pressure. There were no significant correlations between HbA1c and measures of cardiac structure or function. The right ventricular diastolic function was poorer in the T1DM subjects compared to the controls. Thus, the disease duration independently predicts left ventricular enlargement in this population of Sub-Saharan youths (who have relatively poor glycemic control). [ABSTRACT FROM AUTHOR]