Diabetic heart disease: A clinical update.

Area of Science:

• Cardiology
• Endocrinology
• Diabetology

Background:

• Diabetes mellitus (DM) is a major risk factor for cardiovascular complications, driving significant healthcare costs.
• Diabetic heart disease includes coronary artery disease (CAD), cardiac autonomic neuropathy (CAN), and diabetic cardiomyopathy (DCM).
• DM-associated CAD presents with higher prevalence, earlier onset, and increased severity compared to non-diabetics.

Purpose of the Study:

• To provide a comprehensive overview of diabetic heart disease.
• To elucidate the pathophysiology, clinical presentation, diagnosis, and management of DM-related cardiac conditions.
• To equip clinicians with essential knowledge to mitigate morbidity and mortality in diabetic patients.

Main Methods:

• This review synthesizes current clinical knowledge and research findings.
• It examines the specific characteristics of CAD in diabetic patients.
• It addresses the under-recognized complications of CAN and DCM in diabetes.

Main Results:

• DM confers a 2- to 4-fold increased risk of CAD.
• CAN results from damage to cardiac autonomic nerves due to uncontrolled diabetes.
• DCM arises from complex pathophysiological processes damaging cardiomyocytes, diagnosed when other causes are excluded.

Conclusions:

• Optimal DM management can reduce diabetic heart disease risk but is often challenging.
• Clinicians must understand diabetic cardiac illness to improve patient outcomes.
• This review aims to update the scientific community on diabetic heart disease.