CMHC Pulse Blog

An in-depth session titled “Heart Failure: The Frequent, Forgotten, and Often Fatal Complication of Type 2 Diabetes” was presented last week at the American Association of Clinical Endocrinology’s 26th Annual Scientific and Clinical Congress. The cited evidence and research pointed to a high frequency of heart failure, accompanied by an increased risk of mortality, for patients with diabetes.

The conclusion that heart failure requires increased scrutiny, as a risk factor and complication of type 2 diabetes, has been oft quoted and researched—yet it is still not widely known how common the condition is. While microvascular effects of type 2 diabetes are well known and understood—such as neuropathy and diabetic retinopathy—and macrovascular conditions including stroke and peripheral vascular disease, heart failure almost inevitably raises mortality.

Researchers at the University of Alabama at Birmingham School of Medicine have performed series of clinical trials in an effort to determine whether or not heart failure should be more rigorously treated, in order to alleviate and mitigate the poor outcomes often seen in patients. Conclusions indicate that between 40 and 45 percent of patients with diabetes in the United States suffer from heart failure, vs. 12 percent of non-diabetes.

David S.H. Bell, MD showcased studies that specifically assessed and evaluated the complex effects of diabetes and contributing factors to the three primary causes of the heart failure, while other physicians highlighted relations between glycemic control and heart failure risk—focusing on strong correlations between the high incidence of heart failure and type 2 diabetes. Other researchers pointed to the fact that autonomic system dysfunction, a predictor of cardiovascular risk, often occurs in pre-diabetes—which might offer opportunities for early intervention. Technological advancements of the past decade currently allow for identification of the early stages of autonomic dysfunction, through the utilization of concrete, tangible standardized measurements.

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