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Heart failure management; a perspective from diabetes care.
1Clalit Health Services, Haifa, Israel.
Diabetes Research and Clinical Practice
|May 6, 2021
Summary
Type 2 diabetes (T2DM) significantly increases heart failure (HF) risk. This review examines integrating HF prevention and management into routine diabetes care, highlighting new therapies like SGLT-2 inhibitors.
Area of Science:
- Endocrinology
- Cardiology
- Internal Medicine
Background:
- Individuals with type 2 diabetes (T2DM) face a 2-4 times higher risk of heart failure (HF).
- Traditional diabetes care prioritizes microvascular and arterial disease prevention, overlooking HF as a primary complication.
- Existing diabetes management strategies (glucose, BP, lipid control) indirectly benefit HF incidence.
Purpose of the Study:
- To review the integration of heart failure (HF) prevention and management into ambulatory diabetes care.
- To discuss the evolving role of diabetologists in addressing advanced complications like HF.
- To highlight recent therapeutic advancements impacting HF in diabetic patients.
Main Methods:
- Review of current clinical practices in ambulatory diabetes care.
- Analysis of the impact of existing and novel glucose-lowering therapies on HF.
- Perspective from diabetologists on clinical management strategies.
Main Results:
- Sodium glucose transporter inhibitors 2 (SGLT-2 inhibitors) demonstrate significant benefits in reducing HF hospitalizations, even in non-diabetic individuals.
- Renin-angiotensin system (RAS) blockers, commonly used in diabetes care, also contribute to HF prevention.
- The complexity and prevalence of T2DM have historically limited focus on advanced complications like HF.
Conclusions:
- There is a need to incorporate HF prevention and management more explicitly into routine diabetes care.
- Novel glucose-lowering agents, particularly SGLT-2 inhibitors, offer significant cardioprotective benefits.
- A collaborative approach between diabetologists and cardiologists is crucial for comprehensive patient management.
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