Stage-Based Management of Type 2 Diabetes Mellitus with Heart Failure

Methodist Debakey Cardiovasc J. 2018 Oct-Dec;14(4):257-265. doi: 10.14797/mdcj-14-4-257.

Abstract

Type 2 diabetes negatively impacts heart failure outcomes. Insulin resistance, central adiposity, dyslipidemia, and altered cellular substrate metabolism each have a mechanistic role. Management strategies focused solely on glycemic control have had limited success. However, three new classes of drugs, each with several options, offer the promise of improved diabetes management in heart failure. Unlike earlier classes, these medications have had favorable cardiovascular outcomes. In this review, we present a therapeutic guide for metabolic treatment based on the stages of heart failure.

Keywords: DPP-4 inhibitors; GLP-1 agonists; SGLT2 inhibitors; heart failure; therapeutic options; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Clinical Decision-Making
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Cardiomyopathies / diagnosis
  • Diabetic Cardiomyopathies / drug therapy*
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / physiopathology
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Predictive Value of Tests
  • Risk Factors
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents