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Heart failure in people with type 2 diabetes vs. those without diabetes: A retrospective observational study from
Arutselvi Devarajan1, Kirubakaran Karuppiah2, Rubini Venkatasalam1
1M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research, Education and Training in Diabetes) (IDF Centre for Excellence in Diabetes Care), Royapuram, Chennai, Tamil Nadu, India.
Insights
Diabetes significantly impacts heart failure (HF) risk. This study compared clinical features of diabetic patients with and without HF, finding key differences in age, hypertension, and HF type (HFpEF vs. HFrEF).
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Diabetes Mellitus (DM) is an independent risk factor for Heart Failure (HF).
- However, not all individuals with DM develop HF, indicating other contributing factors.
- Understanding the clinical differences between diabetic and non-diabetic patients with and without HF is crucial for risk stratification and management.
Purpose of the Study:
- To compare the clinical features of diabetic patients with Heart Failure (DM-HF) against diabetic patients without HF.
- To compare the clinical features of diabetic patients with Heart Failure (DM-HF) against non-diabetic patients with Heart Failure (non-DM-HF).
- To identify distinct clinical profiles associated with HF in the context of diabetes.
Main Methods:
- A retrospective observational study involving 397 individuals from two tertiary care centers.
- Participants were categorized into four groups: DM with HF (DM-HF), DM without HF, non-DM with HF (non-DM-HF), and non-DM without HF.
- Clinical profiles were assessed and compared between DM-HF vs. DM without HF, and DM-HF vs. non-DM-HF groups.
Main Results:
- Significant differences were observed in age, BMI, BP, and eGFR across the groups.
- DM-HF patients were significantly older than DM without HF patients (58.9 ± 9.2 vs. 49.5 ± 9.3 years; p < 0.001).
- DM-HF showed higher prevalence of hypertension and Coronary Artery Disease (CAD). Notably, DM-HF predominantly presented with HF with preserved Ejection Fraction (HFpEF) (91.2%), while non-DM-HF had a higher proportion of HF with reduced Ejection Fraction (HFrEF) (43.5%).
Conclusions:
- The DM-HF group exhibited significant differences in age, diabetes duration, HbA1c levels, and prevalence of hypertension and CAD compared to other groups.
- Diabetic patients with HF are characterized by older age, longer diabetes duration, and a higher likelihood of hypertension, CAD, and HFpEF.
- These findings highlight distinct clinical characteristics of HF in diabetic populations, emphasizing the importance of considering diabetes status in HF management.
Background And Aim:
Despite diabetes being an independent risk for HF, only some DM patients develop HF and hence our aim was to compare the clinical features of DM with and without HF and non-DM with and without HF.
Methods:
A retrospective observational study was conducted among 397 individuals who visited two tertiary care centres. They were classified into 4 groups - DM with HF(DM-HF), DM without HF, non-DM with HF(non-DM-HF) and non-DM without HF. We assessed and compared the clinical profile of DM with HF vs. DM without HF and non-DM with HF groups respectively.
Results:
The parameters such as age, BMI, BP, eGFR showed significant difference between the groups. People with DM-HF were older compared to DM without HF group(58.9 ± 9.2vs.49.5 ± 9.3; p < 0.001). An increasing trend was observed in HF prevalence with increasing duration of DM among the DM-HF group. DM-HF showed a higher prevalence of hypertension and coronary artery disease(CAD) by history than DM without HF group. DM-HF group(91.2%) had HF with preserved left ventricular ejection fraction(HFpEF) whereas a high proportion(43.5%) of non-DM-HF group had HF with reduced LV ejection fraction(HFrEF).
Conclusions:
The DM-HF group differed from other groups significantly in age, diabetes duration, HbA1c level, prevalence of hypertension, CAD and HFpEF.
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