Diabetes, left ventricular systolic dysfunction, and chronic heart failure
Abstract
Chronic heart failure (HF) and diabetes mellitus (DM) commonly coexist. Each condition increases the likelihood of developing the other, and when they occur together in the same patient the risk of morbidity and mortality increases markedly. We discuss the epidemiological overlap and consider the complex patho-physiological pathways linking the two diseases. The treatment of each condition is made more problematic by the presence of the other. We review the evidence-based treatment strategies and discuss the common problems faced by physicians when treating patients with both conditions. This article forms a comprehensive overview of a fascinating intersection between two common diseases.
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HFrEF is an independent predictor of fatal and non-fatal clinical outcomes in patients with T2DM.
“Conversely, HFrEF is an independent predictor of fatal and non-fatal clinical outcomes in patients with T2DM.2,3”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [2]
Previous concerns that metformin may cause metabolic acidosis are no longer justified.
“Previous concerns that metformin may cause metabolic acidosis are no longer justified.2”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [2]
In large observational studies, insulin is associated with higher mortality rates than metformin.
“In large observational studies, insulin is associated with higher mortality rates than metformin.2”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [2]
In large observational studies, metformin was associated with lower mortality and HF hospitalization rates than other T2DM drugs (primarily insulin and sulphonylureas).
“This was based on large observational studies where metformin was associated with lower mortality and HF hospitalization rates than other T2DM drugs (primarily insulin and sulphonylureas). 2”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [2]
Sulphonylureas have also been associated with higher death rates than metformin.
“There have been similar concerns with sulphonylureas which, as insulin secretagogues, have also been associated with higher death rates than metformin.2”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [2]
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Phenformin-Associated Lactic Acidosis: Pathogenesis and Treatment
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Functional class in patients with heart failure is associated with the development of diabetes
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The Association of Heart Failure With Insulin Resistance and the Development of Type 2 Diabetes
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Pioglitazone initiation and subsequent hospitalization for congestive heart failure
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Left ventricular systolic dysfunction in 75-year-old men and women. A population-based study
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β1- andβ2-Adrenoceptor-Mediated Thermogenesis and Lipid Utilization in Obese and Lean Men1
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“Insulin resistance, in the absence of DM, is an independent prognostic indicator in HF.45 Similarly, an admission blood glucose of .10 mmol/L is a predictor of mortality, independent of DM, in patients with a first hospitalization for HF.46 Why do patients with heart failure develop insulin resistance?”
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Betablocker treatment in diabetes mellitus
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Diabetes lowers six-minute walk test performance in heart failure
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Glucose and haemoglobin in the assessment of prognosis after first hospitalisation for heart failure
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Self-citationSpironolactone in Patients with Heart Failure
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Decreased Survival in Diabetic Patients with Heart Failure Due to Systolic Dysfunction
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Prevalence and characteristics of diabetic patients in a chronic heart failure population
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Diabetes Lowers Aerobic Capacity in Heart Failure
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Diabetes affects long-term survival after heart transplantation
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Seferović, P. M., Petrie, M. C., Filippatos, G. S., Anker, S. D., Rosano, G., Bauersachs, J., Paulus, W. J., Komajda, M., Cosentino, F., de Boer, R. A., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1170 · Cited by 708 · see citing works
Self-citationMetformin: An Old But Still the Best Treatment for Type 2 Diabetes
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Self-citationMean HbA1c and mortality in diabetic individuals with heart failure: a population cohort study
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Metformin Therapy and Outcomes in Patients With Advanced Systolic Heart Failure and Diabetes
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CD38 promotes angiotensin II‐induced cardiac hypertrophy
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Self-citationMacDonald, M. R., Jhund, P. S., Petrie, M. C., Lewsey, J. D., Hawkins, N. M., Bhagra, S., Munoz, N., Varyani, F., Redpath, A., Chalmers, J., et al. (2008) · Circulation Heart Failure · doi:10.1161/circheartfailure.108.794008 · Cited by 64 · see citing works
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- Authors
- MacDonald, M. R., Petrie, M. C., Hawkins, N. M., Petrie, J. R., Fisher, M., McKelvie, R., Aguilar, D., Krum, H., & McMurray, J. J. V.
- Affiliations
- Glasgow Royal Infirmary (GB)
- Aintree University Hospital (GB)
- University of Dundee (GB)
- McMaster University (CA)
- Baylor College of Medicine (US)
- The Alfred Hospital (AU)
- Western Infirmary (GB)
- Corresponding author
- MacDonald, Michael R.
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-04-18
- Volume
- 29
- Issue
- 10
- Pages
- 1224-1240
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2016818962
- Semantic Scholar
- e50d19e468359de0bcfe47f8d112acd285cad128
- Cited by
- 227
- References
- 135
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 11 · 2023: 9 · 2022: 8 · 2021: 15 · 2020: 17 · 2019: 14 · 2018: 13 · 2017: 13 · 2016: 14 · 2015: 19 · 2014: 18 · 2013: 12 · 2012: 11
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes mellitus, chronic heart failure, left ventricular systolic dysfunction, comorbidities, pathophysiological pathways, treatment options, morbidity and mortality risk
- MeSH terms
- Blood Glucose, Cardiotonic Agents, Chronic Disease, Diabetic Angiopathies, Humans, Hypoglycemic Agents, Insulin Resistance, Prognosis, Risk Factors, Heart Failure, Systolic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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