Aim: to identify risk factors for left ventricular (LV) diastolic dysfunction in type 1 diabetes (T1D) and evaluate their diagnostic and prognostic relevance for the development of DD. Patients and Methods: the study included 140 T1D patients (72 men and 68 women) with disease duration more than 3 years who are permanent residents of the Trans-Baikal region. The mean age was 32 years [26.5; 40] and the disease duration was 8 years [6; 11]. All patients were diagnosed with diabetes-associated cardiovascular autonomic neuropathy (CAN) and underwent echocardiography to evaluate LV DD using standard techniques. Serum levels of matrix metalloproteinases (MMPs), i.e., MMP-1, MMP-2, and MMP-3 were measured. In addition, the T(786)C NOS3 gene polymorphism was studied. Relevant risk factors for LV DD in patients with T1D were identified using binary logistic regression Results: 59 patients (42%) with T1D were diagnosed with diabetes-associated CAN. LV DD was diagnosed in 39 patients (27.8%) based on echocardiography. A significant increase in MMP-1 levels was revealed in T1D patients with LV DD, thereby illustrating the role of MMP activation for diabetic cardiomyopathy development. The risk of LV DD in patients with T1D is higher in homozygotic TT NOS3 Т(786)С genotype Conclusions: a model to predict the risk of LVDD based on MMP-1 level, the presence of diabetes-associated CAN, and homozygotic TT NOS3 gene variant was created using binary logistic regression. This model provides a timely diagnosis of diabetes-associated CAN in these patients. KEYWORDS: type 1 diabetes, left ventricular diastolic function, diabetic cardiomyopathy, matrix metalloproteinase-1, T(786)C NOS3 gene polymorphis FOR CITATION: Prosyanik V.I., Serebryakova O.V., Serkin D.M. Predicting the development of left ventricular diastolic dysfunction in type 1 diabetes. Russian Medical Inquiry. 2023;7(9):566–571 (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-2.