Interní Med. 2013; 15(6-7): 220-224

Diabetes and heart failure

doc.MUDr.Jozef Bulas, CSc., prof.MUDr.Ján Murín, CSc.

I. interná klinika, LF UK a UN Bratislava

Diabetes mellitus and heart failure are nowadays both diseases having an epidemic characteristics. Diabetes seems to be an engine of

heart failure development. More severe heart failure forms show more frequently the presence of diabetes. This is true for both systolic

and diastolic heart failure types. In the pathophysiology of heart failure in diabetics there is an influence of myocardial ischaemia, of

meta bolic (lipidic and diabetic) serum changes and of diabetic cardiomyopathy. Also activation of the renin- angiotensin-aldosterone

system is important: mainly the alternative pathway where enhanced activity of ACE-2 enzyme seems to be present. The authors present

here dinical signs of heart failure and also the management of heart failure in diabetics. He discusses the problem of strict versus normal

control of serum glycaemia, and also the pharmacological treatment of diabetes, mostly from the safety point of view. The benefitial drug

is metformin, we can also use the sulphonylurea derivateves, insulin, and very promissing drugs are incretines. The occurence of type

2 diabetes and heart failure increases and will increase. It is therefore necessary to search for diabetes, to do preventive measures and

support healthy way of life as the pre vention is here better than treatment.

Keywords: diabetes mellitus, heart failure, diabetic cardiomyopathy, antidiabetics

Published: July 15, 2013  Show citation