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Heart Failure in Type 1 vs. Type 2 Diabetes Mellitus: Shared Pathways, Distinct Challenges.

Muhammad S Hussain1, Saraswathi Iyer1, Yi Jia Liew1

  • 1Division of Cardiovascular Research, University of Dundee, Dundee, Scotland, UK, dundee.ac.uk.

Journal of Diabetes Research
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

Heart failure (HF) is a serious complication for people with type 1 (T1D) and type 2 diabetes (T2D). This review highlights key differences in HF epidemiology, pathophysiology, and outcomes between T1D and T2D.

Keywords:
GLP-1RA and finerenoneHFpEFHFrEFSGLT-2i inhibitors and Sotagliflozincardiac microvascular dysfunction (CMD)heart failure (HF)type 1 diabetes (T1D)type 2 diabetes (T2D)

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Area of Science:

  • Cardiology
  • Endocrinology
  • Diabetology

Background:

  • Heart failure (HF) is a critical complication in both type 1 diabetes (T1D) and type 2 diabetes (T2D).
  • Individuals with diabetes exhibit a higher risk of developing HF compared to the general population.
  • Diabetic cardiomyopathy, characterized by insulin deficiency, insulin resistance, inflammation, and myocardial fibrosis, underlies HF in diabetes.

Purpose of the Study:

  • To review the burden, pathophysiology, and outcomes of HF in patients with diabetes.
  • To emphasize the distinct differences in HF between T1D and T2D.
  • To identify the unmet needs in managing T1D patients with HF.

Main Methods:

  • Literature review of existing studies on HF in diabetes.
  • Comparative analysis of epidemiological data, pathophysiological mechanisms, treatment strategies, and clinical outcomes.
  • Focus on differentiating HF characteristics in T1D versus T2D.

Main Results:

  • Similarities and key differences in HF epidemiology and pathophysiology exist between T1D and T2D.
  • Treatment approaches and clinical outcomes for HF also vary between T1D and T2D.
  • A significant unmet need exists for T1D patients experiencing HF.

Conclusions:

  • Understanding the specific nuances of HF in T1D and T2D is crucial for effective management.
  • Further research and targeted therapies are required, particularly for T1D patients with HF.
  • Addressing the unmet needs in T1D-associated HF is a priority for improving patient outcomes.