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Heart failure management; a perspective from diabetes care

Lookup NU author(s): Emeritus Professor Philip Home


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© 2021 Elsevier B.V.People with type 2 diabetes (T2DM) are recognized as having a 2–4 times increased risk of heart failure (HF). Ambulatory diabetes care has long concentrated on the prevention of microvascular and arterial disease, and surveillance for manageable problems such as with the feet and retinae. Accordingly, management of heart failure has never been a specific focus, although the preventative management of cardiac and kidney disease through glucose-lowering, blood pressure (BP) control, and blood lipid control, have had a positive impact on its incidence. Indeed, the very complexity of routine diabetes care, and its enormous prevalence, has generally excluded the management of any of the advanced late complications, whether cardiac, arterial, retinal, renal, or neurodegenerative. Furthermore, advances in HF management itself, in diagnostics, medications, and technology, has carried it deeper into the remit of specialist cardiological care. More recently and in addition to medications already routinely used in diabetes care such as renin-angiotensin system (RAS) blockers, some glucose-lowering therapies such as sodium glucose transporter inhibitors 2 (SGLT-2 inhibitors), have been found to have very positive effects on hospitalization for HF, indeed even in people who do not have T2DM. Here, from the perspective of the diabetologist, we review the clinical scenario of ambulatory diabetes care, in regard of how HF prevention and management should fit in to clinical practice.

Publication metadata

Author(s): Itzhak B, Home P

Publication type: Article

Publication status: Published

Journal: Diabetes Research and Clinical Practice

Year: 2021

Volume: 176

Print publication date: 01/06/2021

Online publication date: 04/05/2021

Acceptance date: 29/04/2021

ISSN (print): 0168-8227

ISSN (electronic): 1872-8227

Publisher: Elsevier Ireland Ltd


DOI: 10.1016/j.diabres.2021.108849

PubMed id: 33957144


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