How Diabetes and Heart Failure Modulate Each Other and Condition Management.

Abstract: Heart failure (HF) and diabetes mellitus (DM) confer considerable burden on the healthcare system. Although these often occur together, DM can increase HF risk, while HF can accelerate DM complications. HF is a clinical syndrome resulting from systolic and/or diastolic impairment caused by ischemic, non-ischemic (e.g., DM) or other etiologies. HF exists along a spectrum, from stage A (i.e., at-risk DM persons) to stage D (i.e., refractory HF from end-stage DM cardiomyopathy (DMCM)). HF is further categorized by reduced, midrange and preserved ejection fraction (EF). In type 2 DM, the most prevalent form of DM, several pathophysiological mechanisms (e.g., insulin resistance, hyperglycemia, etc) can contribute to myocardial damage leading to DMCM. HF and DM management and patient outcomes are guided by EF and drug efficacy. In this review, we focus on the interplay between HF and DM on disease pathophysiology, management, and patient outcomes. Specifically, we highlight the role of novel anti-hyperglycemic (e.g., sodium glucose co-transporter 2 inhibitors) and HF therapies (e.g., renin-angiotensin-aldosterone system inhibitors) on HF outcomes in DM and HF patients.