The heart of diabetes: unraveling metabolic drivers of cardiomyopathy

Abstract

Diabetes mellitus (DM) ignites a global epidemic, with cardiovascular complications claiming most lives among affected patients. Diabetic cardiomyopathy (DCM), a distinct cardiac dysfunction triggered by DM independent of coronary artery disease or hypertension, threatens those with type 1 or type 2 DM, often leading to heart failure. In type 2 DM (T2DM), metabolic disruptions drive cardiac lipotoxicity. Yet, how lipotoxicity impairs function and DM sparks clinical syndromes remains unclear. This review unveils how DM rewires myocardial metabolism-favoring lipids over glucose-and probes emerging therapies, spotlighting clinical challenges at a vital research frontier.