Heart failure and diabetes

Authors: Ján Murín;  Jozef Bulas
Authors‘ workplace: I. interná klinika LF UK a Nemocnica Staré Mesto, UNB, Bratislava, prednostka doc. MUDr. Soňa Kiňová, PhD.
Published in: Forum Diab 2013; 2(1): 18-22


Diabetes mellitus and heart failure are nowadays both diseases of epidemic characteristics. Diabetes seems to be an engine of heart failure development. More severe heart failure forms have more frequently presence of diabetes. This is true for both systolic and diastolic heart failure types. In the pathophysiology of heart failure in diabetics there is an influence of myocardial ischaemia, of metabolic (lipidic and diabetic) serum changes and of diabetic cardiomyopathy. Also activation of renin-angiotensin-aldosterone system is important, mainly the alternative pathway where enhanced activity of ACE2 enzyme seems to be present. Author presents clinical signs of heart failure here and also management of heart failure in diabetics. He is discussing the problem of strict versus of normal control of serum glycaemia and also pharmacologic treatment of diabetes, mostly from safety points of view. The topic is important for clinical practice and points to the management of heart failure in diabetics. The prevention is here better than the treatment.

Key words:
diabetes mellitus – heart failure – diabetic cardiomyopathy – antidiabetics


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