Key result
Type 2 diabetes mellitus substantially increases the lifetime risk of developing and dying from heart failure, with putative mechanisms including adverse effects of hyperglycemia and fatty acids.
Highlights the pathophysiologic mechanisms linking type 2 diabetes and heart failure, suggesting that metabolic control might delay or prevent heart failure development.
Supports HF surveillance in T2DM; leaves open whether metabolic control prevents incident HF in trials.
Type 2 diabetes mellitus substantially increases the lifetime risk of both developing and dying from heart failure. While this appears to be explained in part by the well-known association of diabetes with hypertension, dyslipidemia, and coronary atherosclerosis, additional pathophysiologic mechanisms linking type 2 diabetes and heart failure have recently been suggested. These include the potentially adverse effects of hyperglycemia on endothelial function and redox state, effects of excess circulating glucose and fatty acids on cardiomyocyte ultrastructure, intracellular signaling and gene expression, and the possibility that diabetes may impair recruitment of the myocardial insulin-responsive glucose transport system in response to ischemia. Because many of these putative pathophysiologic mechanisms should be amenable to normalization of the diabetic metabolic milieu, strategies designed to more carefully control circulating levels of glucose and fatty acids might conceivably delay or prevent the development of heart failure.
No takes yet. Share an insight, caveat, or question.
Jagasia et al. (2003) conducted a review in Type 2 diabetes mellitus and heart failure. Type 2 diabetes mellitus was evaluated. Type 2 diabetes mellitus substantially increases the lifetime risk of developing and dying from heart failure, with putative mechanisms including adverse effects of hyperglycemia and fatty acids.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: