Type 2 Diabetes May Affect Heart Structure

The prevalence of diabetes mellitus has increased worldwide during the past 3 decades, with the largest projected increases occurring in Asia. Diabetes mellitus increases the risk of developing heart failure (HF); also patients with both conditions are known to have particularly poor outcomes. Most previous studies of diabetes mellitus and HF have focus on Western populations; also data on the relationship between diabetes mellitus and HF phenotypes in Asia are lacking.

Coexists with heart failure

Knowledge gleaned from Western cohorts may not be readily extrapolate to Asians; particularly in light of recent studies showing distinct differences between Asians and white populations. Type 2 diabetes affects the structure of the heart in heart failure patients; also increases their risk for repeat hospitalizations and/or death; so according to new research publish in the Journal of the American Heart Association; so the Open Access Journal of the American Heart Association/American Stroke Association.

Type 2 diabetes frequently coexists with heart failure; also the prevalence of diabetes has increase worldwide. While diabetes and heart failure together have extensively studied among Western populations; there is less know about their collective impact among Asian populations. An international team of researchers analyze data from more than nearly 6,200 heart failure patients participating in the ASIAN-HF Study.

The study found that having Type 2 diabetes and heart failure was associate with; structural abnormalities in the heart; poorer quality of life; and increased risk of heart failure-related re-hospitalizations and/or death within one year. Researchers also noted that the overall prevalence of Type 2 diabetes was high among these heart failure patients; with more than 40% having diabetes. The prevalence was highest in Singapore and Hong Kong.

Cardiovascular deaths

We found that the most common causes of cardiovascular deaths in patients with HF were the same in those with or without diabetes mellitus (namely, SCD, followed by HF‐related events). This is consistent with outcomes in the I‐PRESERVE trial. Patients with HF and diabetes mellitus were not receiving optimal medical therapy for HF or diabetes mellitus.

The uptake of angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers and mineralocorticoid receptor antagonists was lower in patients with diabetes mellitus than in those without; despite good safety data and proven benefits. Uptake of metformin was fairly low, despite current guidelines that recommend metformin as the first‐line agent unless contraindicated as well as good safety data of metformin in HF.

“Primary prevention strategies and tailored treatment options are need to tackle this twin scourge of diseases,” said study co-author Jonathan Yap, M.B.B.S., M.P.H., consultant from the department of cardiology of the National Heart Centre Singapore. “Our findings emphasize the need for preventative public health measures at the community and primary care level. For heart failure patients who have diabetes, physicians should closely monitor and optimize their management.”