Diabetes mellitus independently increases mortality by 30% to 50% in patients with heart failure with preserved ejection fraction compared to those without diabetes.
In patients with HFpEF and diabetes, biguanides and SGLT2 inhibitors improve heart failure outcomes, while thiazolidinediones worsen outcomes and should be avoided.
The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is complex and poorly understood. There is a high prevalence of Diabetes Mellitus (DM) in patients with HFpEF, and the presence of DM has been shown to increase mortality of patients with HFpEF by 30%-50% even after adjustment for age, gender, hospital factors, and other patient characteristics. Since the prevalence of both entities is increasing worldwide, there is a need to explore their intricate relationship in order to elucidate potential management strategies to reduce the morbidity and mortality associated with this duo. In this review article, we explore the role of DM in the pathophysiology of HFpEF, ethnic and gender differences, and some therapeutic strategies in the management of patients with HFpEF and DM.
Mgbemena et al. (2021) conducted a review in Heart Failure with Preserved Ejection Fraction and Diabetes Mellitus. Diabetes Mellitus vs. Without Diabetes Mellitus was evaluated. Diabetes mellitus independently increases mortality by 30% to 50% in patients with heart failure with preserved ejection fraction compared to those without diabetes.