Aim. To evaluate vasomotor function of arterial endothelium and homocysteine level in hemodynamic disturbances in patients with type 2 diabetes mellitus (DM2). Material and methods. We observed 134 patients (63 men and 71 women). Average age was 59.3±4.7 years. Comprehensive examination including echocardiography, vascular ultrasound, ECG monitoring and blood pressure, determination of homocysteine, lipid and carbohydrate metabolism was performed. Results. In patients with type 2 diabetes endothelial vasomotor dysfunction was diagnosed: in group I endothelium-dependent vasodilation of the brachial artery was 3.7±1.3%, in II group — 7.3±2.1%, that was significantly lower compared with the control group — 12.3±2.2%; p<0.03. In patients with type 2 diabetes, coronary artery disease and hypertension (group I) absence of brachial artery diameter growth and abnormal vasoconstriction were revealed in 30.4 and 10.9% respectively in response to reactive hyperemia test. Insufficient vasodilating effect was observed 58.7% of patients. Moderate hyperhomocysteinemia was defined in 82.6, 58.3 and 15% in groups I, II and control group respectively. Analysis of left ventricular structural and functional status showed a moderate negative correlation of homocysteine level with E’/A’ (r= –0.34; p<0.03), E/E’ (r=–0,31; p<0.05). Conclusion. In patients with diabetes mellitus, hyperglycemia and hyperhomocysteinemia impaired functional endothelial state contributes to progression of cardiovascular events: myocardial ischemia and left ventricular diastolic dysfunction.