Background: Diabetes mellitus type 2 (T2DM) is a prevalent metabolic disease that predisposes to diabetic cardiomyopathy and cardiovascular diseases (CVD). High sensitivity cardiac troponin T (hs-cTnT) can determine who is most at risk for developing cardiovascular issues and diabetes. Objective: To evaluate the relation between high-sensitive cardiac troponin T and cardiac metabolic risks (hypertension and truncal obesity) in patient with T2DM. Patients and Methods: A prospective cohort study included 50 diabetic patients reached at the emergency units of Mansoura University Hospital and Al-Azhar University Hospital in Egypt, for one year-duration from May 2021 to May 2022. All of the patients had been subjected to physical examination, medical and family diabetes history. Laboratory tests, included hs-cTnT, and truncal obesity measurement also were reported. Results: The biomarker hs-cTnT was found in 32 (64%) of the patients. A strong significant correlation was detected between hs-cTnT and systolic blood pressure (SBP), diastolic blood pressure (DBP), hypertension, and truncal fat by dual-emission X-ray absorptiometry (DXA); with p-value (0.007, 0.006, 0.006, 0.001) respectively. Besides, no significant correlation was detected between hs-cTnT and the duration of diabetes, RBG, HBA1c, and BMI. Furthermore, the mean truncal fat of study population that detected by DXA scan was ranged from 8 Kg to 24 Kg with mean + SD = 14.5 + 4.51 Kg. Conclusion: The biomarker hs-cTnT and truncal fat might be associated with cardiac metabolic risks in patient with T2DM.