Vnitr Lek 2019, 65(4):307-313 | DOI: 10.36290/vnl.2019.054

Diabetes Mellitus and Chronic Heart Failure

Jindřich Špinar^1,3,*, Lenka Špinarová^2,3, Jiří Vítovec^2,3

¹ Interní kardiologická klinika LF MU a FN Brno, pracoviště Bohunice

² I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně

³ Mezinárodní centrum klinického výzkumu (ICRC) FN u sv. Anny v Brně

Diabetes mellitus is one of the major risk factors for many cardiovascular diseases, primarily ischemic heart disease and heart failure. In patients with heart failure, the incidence of diabetes mellitus is 3-4 times greater than in non-cardiac patients and is reported to be about 40%. Diabetic cardiomyopathy is a term that expresses the relationship between diabetes mellitus and heart disease. Regarding the treatment of heart failure in patients with diabetes mellitus, the general principles of heart failure therapy apply. In most studies, the effect of ACE inhibitors was greater in diabetics than in non-diabetics, the effect of beta-blockers was comparable or rather minor. Type 2 diabetics with heart failure due to impaired resorption and metabolism will need insulin more often than diabetics without heart failure. Of the new drug groups, DPP-4 inhibitors and GLP-1 agonists have not proved efficient for heart failure, but SGLT-2 inhibitors which are likely to have antihypertensive and diuretic effects and improve prognosis of heart failure, are very promising.

Keywords: diabetes mellitus; heart failure; prognosis; SGLT2

Received: August 30, 2018; Accepted: January 31, 2019; Published: April 1, 2019  Show citation