Diabetes treatment can help in heart failure as well

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Having Type 2 diabetes or heart failure independently increases the risk for getting the other, and both often occur together, further worsening a patient’s health, quality of life and care costs, a new report says. Recent studies have found new treatments for diabetes may also improve heart failure outcomes, showing the interplay between the two conditions, the report says.

Many of the risk factors and mechanisms behind Type 2 diabetes and heart failure are similar, according to a statement from the American Heart Association and the Heart Failure Society of America published in the journal Circulation.

It’s not uncommon for a patient to see a cardiologist for heart failure and then visit a primary care doctor or endocrinologist for help managing diabetes, she said. But physicians need to be aware of how medications used for one condition affect the outcome of another.

“There’s so much new data coming out all the time. We want to bring attention to the fact that diabetes and heart failure have substantial overlap, and it’s important to stay up to date on new information,” said Shannon Dunlay, a heart failure cardiologist at the Mayo Clinic in Rochester, Minnesota.

DIABETICS MORE LIKELY TO DEVELOP HEART FAILURE
People who have Type 2 diabetes, characterized by elevated blood sugar levels, are two to four times more likely to develop heart failure than someone without diabetes. But heart failure, a condition in which the heart fails to efficiently pump oxygenated blood through the body, also is a risk factor for diabetes.

Both disorders are characterized by insulin resistance and high levels of inflammation, said Dr. Rozalina McCoy, another member of the statement’s writing committee.

“People who have both these conditions have a much higher risk of worse health outcomes — more hospitalizations, more emergency department visits, earlier death, and worse health overall than people who have just one of these conditions,” said McCoy, an endocrinologist and internal medicine physician at Mayo Clinic.

KEEP BLOOD SUGAR UNDER CONTROL
It’s important to get regular exercise, maintain a healthy weight and eat a well-balanced diet. People with diabetes also need to keep their blood sugar levels under control. The statement describes in detail a new class of medications called SGLT-2 inhibitors that lower blood sugar in adults with diabetes. But research shows these drugs also are effective in reducing the risk of developing heart failure and helping manage the condition in those who already have it, preventing heart failure-related hospitalizations and deaths.

It’s important that people with either or both conditions touch base regularly with their doctors, Dunlay said.

“There’s still a lot that we don’t know about how best to manage patients with diabetes and heart failure, but a number of ongoing studies will help to elucidate things further,” she said.

“This is an exciting area in medicine and science right now, and we’re going to find a lot of opportunities to improve patient management and outcomes.”

For more information visit the American Heart Association’s heartinsight.heart.org.


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