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Treating heart failure in patients with diabetes: The view of the cardiologist

Nina Kumowski1, Nikolaus Marx1, Katharina Schütt1

  • 1Medical Clinic I - Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany.

Diabetes Research and Clinical Practice
|May 6, 2021
PubMed

Insights

Heart failure and diabetes comorbidities significantly increase risks. New SGLT-2 inhibitor therapies may change treatment guidelines, impacting when to initiate care for these patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes is a significant comorbidity in heart failure patients, increasing cardiovascular risks.
  • Current heart failure therapies do not typically differentiate based on the presence of diabetes.
  • Emerging SGLT-2 inhibitors show promise in reducing heart failure hospitalizations, irrespective of diabetes status.

Purpose of the Study:

  • To review current treatment recommendations for heart failure in patients with diabetes.
  • To discuss clinical considerations for optimizing therapy in this patient population.
  • To highlight the potential impact of SGLT-2 inhibitors on future treatment guidelines.

Main Methods:

  • Literature review of current guidelines and clinical trial data.
  • Analysis of the role of SGLT-2 inhibitors in heart failure management.
  • Synthesis of clinical considerations for comorbid heart failure and diabetes.

Main Results:

  • SGLT-2 inhibitors have demonstrated efficacy in reducing heart failure hospitalizations, independent of diabetes.
  • These findings are expected to influence upcoming European Society of Cardiology (ESC) heart failure guidelines.
  • The presence of diabetes may become a factor in determining the optimal timing for initiating SGLT-2 inhibitor therapy.

Conclusions:

  • Coexisting diabetes in heart failure patients necessitates careful therapeutic considerations.
  • SGLT-2 inhibitors represent a significant advancement in managing heart failure, with or without diabetes.
  • Early and individualized therapy is crucial for improving outcomes in patients with both conditions.

Keywords:
Cardiovascular outcomesHeart failureHeart failure with preserved ejection fraction (HFpEF)Heart failure with reduced ejection fraction (HFrEF)SGLT-2 inhibitorsType 2 diabetes

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