Abstract

EFFECT OF DIABETES MELLITUS ON HEART FAILURE – A REVIEW

B. Mayuri, B. Pravallika, D. Sudheer Kumar and P. Kishore*

Abstract

Diabetes mellitus, a group of metabolic disorders is characterised with hyperglycemia because of insufficient insulin production or loss of insulin sensitivity of the cells. Heart failure patients with diabetes are associated with higher adverse events compared to those without diabetes. Pathophysiological changes associated with diabetes includes structural and functional alterations, metabolic disturbances such as insulin resistance, vascular disease, endothelial dysfunction, myocardial fibrosis, oxidative stress, accumulation of advanced glycation end products, impaired calcium homeostasis, free fatty acid metabolism, activated leukocytes, cardiac autonomic dysfunction lead to heart failure. American Diabetes Association recommends life style changes along with monotherapy of metformin. Preventive measures of heart failure are the possible initial approaches which would result in positive outcomes. Insulin has positive inotropic effects (increased intra cellular calcium concentration), antioxidant effects (increase the activity of antioxidant enzymes), antiapoptotic effects, anti-inflammatory effects (prevent leukocyte adherence to endothelium) and vascular effects. Considering the therapeutic effects and adverse events, SGLT-2 inhibitors should be used as primary choice of drugs in patients with DM & HF. Our review focusses on pathophysiological events of DM, treatment patterns and non-pharmacological (life style changes &).

Keywords: Heart Failure, Diabetes, Pathophysiological Effects.