Chronic heart failure and diabetes mellitus: Two unsuitably matched partners

Abstract

Diabetes mellitus (DM) and heart failure (HF) are often associated and each disease independently increases the risk for the other. It is well recognized that diabetes is a risk factor for mortality among individuals with heart failure. The risk of incident HF among patients with DM increases with older age, obesity, retinopathy, hypertension, coronary artery disease, peripheral arterial disease, nephropathy, longer duration of DM and higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) value. The treatment of each pathology in the presence of the other raise difficulties in the clinical practice. First-line treatment of DM in patients with HF should include metformin and SGLT2 inhibitors; conversely, saxagliptin, pioglitazone and rosiglitazone are not recommended in patients with DM and HF.