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Diabetic heart disease--current problems and their management.

A K Das

    The Journal of the Association of Physicians of India
    |February 1, 1989
    PubMed
    Summary

    Diabetic heart disease (DHD) involves coronary artery disease, autonomic denervation, and cardiomyopathy. Early detection and management by the diabetic team are crucial for preventing severe outcomes.

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    Area of Science:

    • Cardiology
    • Endocrinology
    • Diabetology

    Background:

    • Diabetic heart disease (DHD) is a significant complication of diabetes mellitus (DM).
    • DHD presents multifactorially, encompassing coronary artery disease (CAD), autonomic cardiac denervation, and diabetic cardiomyopathy.
    • Ancillary factors like obesity, hypertension, and lipid abnormalities exacerbate DHD.

    Purpose of the Study:

    • To review recent advances and clinical experiences in understanding and managing diabetic heart disease.
    • To outline practical management strategies, including early diagnosis, monitoring, and blood glucose control.
    • To discuss preventative measures for diabetic heart disease.

    Main Methods:

    • Review of recent literature and clinical studies (non-invasive, invasive, autopsy).
    • Analysis of experimental studies investigating diabetic cardiomyopathy.
    • Synthesis of practical management experiences from a multidisciplinary diabetic team.

    Main Results:

    • Diabetes mellitus significantly increases the severity and early onset of coronary artery disease, often with atypical presentations.
    • Autonomic cardiac denervation is a common complication linked to diabetic neuropathy, impacting DHD.
    • Evidence supports a specific diabetic heart muscle disease characterized by small vessel disease and metabolic alterations.

    Conclusions:

    • A high index of suspicion, early diagnosis, and close monitoring are essential for managing DHD.
    • Rigid blood glucose control and coordinated multidisciplinary team efforts are vital for effective DHD management.
    • Implementing preventative strategies can mitigate the impact of diabetic heart disease.

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