The concept of diabetic cardiomyopathy evolved in the 1970s from pathology, epidemiology, experimental and invasive clinical studies. However, as structural changes in the diabetic heart involve more than the myocardium, the term 'cardiopathy' is more appropriate. Several nonivasive studies have attempted to elucidate the pathophysiologic hallmarks of the early preclinical phase of left venticular dysfuncion in diabetic subjects. Although these studies do suggest the existence of a specific diabetic cardiopathy, many of them are hampered by a heterogenous selection of study subjects. This introduces confounding factors which often renders these studies difficult to interpret. This review critically evaluates the findings of some of these noninvasive studies and suggests future directions in assessing diabetic cardiopathy.