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Heart Failure in Type 1 Diabetes: A Complication of Concern? A Narrative Review
Ana María Gómez-Perez1,2,3, Miguel Damas-Fuentes1,2, Isabel Cornejo-Pareja1,2,3
1Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain.
Insights
Heart failure (HF) is a serious complication for people with type 1 diabetes (T1D), often leading to worse outcomes than in type 2 diabetes (T2D). Further research into T1D HF is crucial for developing effective prevention and treatment strategies.
Area of Science:
- Cardiology
- Diabetology
- Endocrinology
Background:
- Heart failure (HF) is a significant complication in diabetes mellitus.
- Sodium-glucose cotransporter 2 inhibitors (iSGLT2) have emerged as key treatments for cardiovascular disease and HF, primarily studied in type 2 diabetes (T2D).
- Limited research exists on the epidemiology, etiology, and pathophysiology of HF specifically in type 1 diabetes (T1D).
Purpose of the Study:
- To highlight the growing importance of understanding HF in T1D.
- To underscore the need for investigating HF characteristics, risk factors, and pathophysiology in T1D.
- To inform the development of targeted prevention and therapeutic strategies for T1D-associated HF.
Main Methods:
- Review of current literature on HF in diabetic populations.
- Analysis of emerging data concerning T1D and HF.
- Comparative assessment of HF in T1D versus T2D.
Main Results:
- HF is a common and serious complication in diabetes.
- T1D patients with HF face a worse prognosis compared to T2D patients.
- Increased life expectancy in T1D is leading to a growing elderly T1D population with HF.
Conclusions:
- HF in T1D requires dedicated investigation due to its distinct pathophysiology and poorer prognosis.
- Understanding T1D-specific HF mechanisms is essential for clinical practice.
- Future research should focus on risk stratification, prevention, and novel therapeutic approaches for HF in T1D.
Abstract:
Heart failure (HF) has been a hot topic in diabetology in the last few years, mainly due to the central role of sodium-glucose cotransporter 2 inhibitors (iSGLT2) in the prevention and treatment of cardiovascular disease and heart failure. It is well known that HF is a common complication in diabetes. However, most of the knowledge about it and the evidence of cardiovascular safety trials with antidiabetic drugs refer to type 2 diabetes (T2D). The epidemiology, etiology, and pathophysiology of HF in type 1 diabetes (T1D) is still not well studied, though there are emerging data about it since life expectancy for T1D has increased in the last decades and there are more elderly patients with T1D. The association of T1D and HF confers a worse prognosis than in T2D, thus it is important to investigate the characteristics, risk factors, and pathophysiology of this disease in order to effectively design prevention strategies and therapeutic tools.
