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Cited by 81Cardiovascular Function and Risk FactorsDiabetes Treatment and ManagementCardiac Fibrosis and Remodeling

Diabetes-related cardiomyopathy: the sweet story of glucose overload from epidemiology to cellular pathways

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Joubert, M., Manrique, A., Cariou, B., Prieur, X.·2019·Diabetes & Metabolism
DOI 10.1016/j.diabet.2018.07.003
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Abstract

Type 2 diabetes (T2D) is a major risk factor for heart failure (HF). Although the number of cases of myocardial infarction in the T2D population has been reduced by 25% over the last 10 years, the incidence of HF is continuously increasing, making it the most worrying diabetes complication. This strongly reinforces the urgent need for innovative therapeutic interventions to prevent cardiac dysfunction in T2D patients. To this end, epidemiological, imaging and animal studies have aimed to highlight the mechanisms involved in the development of diabetic cardiomyopathy. Epidemiological observations clearly show that hyperglycaemia correlates with severity of cardiac dysfunction and mortality in T2D patients. Both animal and cellular studies have demonstrated that, in the context of diabetes, the heart loses its ability to utilize glucose, therefore leading to glucose overload in cardiomyocytes that, in turn, promotes oxidative stress, accumulation of advanced glycation end-products (AGEs) and chronic activation of the hexosamine pathway. These have all been found to activate apoptosis and to alter heart contractility, calcium signalling and mitochondrial function. Although, in the past, tight glycaemic control has failed to improve cardiac function in T2D patients, recent clinical trials have reported cardiovascular benefit with hypoglycaemic antidiabetic drugs of the SGLT2-inhibitor family. This review, based on clinical evidence from mechanistic studies as well as several large clinical trials, covers 15 years of research, and strongly supports the idea that hyperglycaemia and glucose overload play a central role in the pathophysiology of diabetic cardiomyopathy.

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Cited by

Sorted by citations

Authors
Joubert, M., Manrique, A., Cariou, B., & Prieur, X.
Affiliations
  • Centre Hospitalier Universitaire de Caen Normandie (FR)
  • Centre National de la Recherche Scientifique (FR)
Corresponding author
Prieur, X.
ORCID
Venue
Diabetes & Metabolism
Publisher
Elsevier BV
Published
2019-06
Volume
45
Issue
3
Pages
238-247
ISSN
1262-3636 (ISSN-L)
DOI
10.1016/j.diabet.2018.07.003
OpenAlex
W2884561768
Cited by
81
References
14
Citations by year
2026: 6 · 2025: 11 · 2024: 14 · 2023: 11 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 7 · 2018: 2
FWCI
1.30
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes & Metabolism (acceptedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by-nc)
Funders
  • Eli Lilly and Company
  • AstraZeneca
  • Sanofi
  • Novo Nordisk
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords
diabetic cardiomyopathy, type 2 diabetes, heart failure, hyperglycemia, glucose overload, cardiomyocytes, oxidative stress, advanced glycation end products, hexosamine biosynthetic pathway, apoptosis, calcium signaling, mitochondrial dysfunction, SGLT2 inhibitors, tight glycemic control, cardiac contractility
MeSH terms
Blood Glucose, Diabetes Mellitus, Type 2, Humans, Hyperglycemia, Risk Factors, Prevalence, Oxidative Stress, Diabetic Cardiomyopathies

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