Clinical aspects of heart failure in individuals with diabetes

Diabetologia. 2019 Sep;62(9):1529-1538. doi: 10.1007/s00125-019-4958-2. Epub 2019 Jul 24.

Abstract

Heart failure (HF) is an important comorbidity in individuals with diabetes. Most commonly, the condition is secondary to ischaemia and hypertension. Diabetic cardiomyopathy is becoming increasingly recognised as a cause of HF and blood glucose control plays a pivotal role in the prevention and treatment of HF. Since the US Food and Drug Administration regulatory guidance in 2008, new glucose-lowering agents are evaluated routinely by cardiovascular outcome trials. These trials offer a wealth of knowledge and allow better understanding of the risks and benefits of contemporary diabetes medications. In this review, we will focus on the risks of HF with emerging glucose-lowering therapies and the safety of these medications in patients with established HF. We will summarise the guidance that is available for the treatment algorithm of diabetes in those with HF and highlight future areas of research.

Keywords: Diabetes; Heart failure; Medical management; Review.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / physiopathology
  • Diabetic Cardiomyopathies / blood
  • Diabetic Cardiomyopathies / etiology*
  • Female
  • Heart Failure / blood
  • Heart Failure / etiology*
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Male

Substances

  • Hypoglycemic Agents