Top Things to Know: Type 2 Diabetes Mellitus and Heart Failure
Published: June 06, 2019
- More than 29 million adults in the United States have type 2 diabetes mellitus, 6.5 million have heart failure (HF), and both conditions are increasing in prevalence.
- These trends forecast a growing burden of disease and underscore the need for effective therapeutic strategies.
- Diabetes is a risk factor for HF and observational studies have consistently demonstrated a 2-4-fold increased risk of HF in individuals with diabetes compared to those without diabetes.
- Poor glycemic control is associated with greater risk for the development of HF; for each 1% increase in HbA1c, the risk of incident HF increases by 8-36%.
- The risk of HF associated with diabetes may be even higher in younger adults and women.
- Recent trials underscore that HF is a critical outcome in patients with diabetes and suggest that glucose-lowering medications may influence the risk of HF development and progression.
- While there are clinical practice guidelines for the management of diabetes and HF as isolated conditions, there is insufficient guidance on caring for patients with both diabetes and HF.
- This joint American Heart Association (AHA)/Heart Failure Society of America (HFSA) statement summarizes current understanding of the epidemiology, pathophysiology, and outcomes of patients with type 2 diabetes and HF.
- A review of data on the efficacy and safety of pharmacologic and lifestyle management options in patients with diabetes at risk for HF and those with established disease is provided.
- Integrated care that actively engages patients, family and providers is key to optimizing both quality and quantity of life for diabetes and HF.
Citation
Dunlay SM, Givertz MM, Aguilar D, Allen LA, Chan M, Desai AS, Deswal A, Dickson VV, Kosiborod MN, Lekavich CL, McCoy RG, Mentz RJ, Pina IL; on behalf of the American Heart Association Heart Failure and Transplantation Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Heart Failure Society of America. Type 2 diabetes mellitus and heart failure: a scientific statement from the American Heart Association and Heart Failure Society of America [published online ahead of print June 6, 2019]. Circulation. doi: 10.1161/CIR.0000000000000691.