Chronic heart failure and diabetes mellitus: Pathogenesis and possibilities of treatment

Abstract

In this article we present data of scientific studies of prevalence of diabetes mellitus (DM) among patients with chronic heart failure (CHF), pathogenetic and risk factors of CHF development patients with DM (hyperglycemia, elevated body mass index, age, ischemic heart disease, nephropathy, proteinuria, DM duration, etc.). The article also contains results of analysis of mortality of patients with and without DM in dependence of ejection fraction value. After characterization of drugs for treatment of CHF in general and specifically in patients with DM we make focus on perspective directions in treatment of this group of patients. Sodium-glucose co-transporter 2 (SGLT2) inhibitors can be effective in patients with DM and CHF, in the first place empagliflozin with proven positive cardiac effects. In obese patients with and without DM efficacy of treatment at the background of lifestyle modification with the help of weight reduction, physical exercise, diet etc has been shown to be effective. In addition, there are data on positive effects of metformin which in patients with CHF and DM lowers availability of energy substrate at the account of reduction of volume of endogenous glucose.