Year: 2025
Type: article
Abstract: Diabetes mellitus and heart failure are two common chronic conditions that frequently coexist, producing outcomes worse than either disease alone. This paper investigates how diabetes directly impairs the myocardium, leading to a distinct syndrome often termed diabetic cardiomyopathy, and examines the reciprocal influence of both disorders. Evidence from clinical and experimental studies highlights altered myocardial metabolism, oxidative stress, glycation pathways, calcium dysregulation, mitochondrial injury, inflammatory signaling, and autonomic imbalance as contributors to structural and functional decline. Analysis of pharmacological data shows that sodium–glucose cotransporter-2 inhibitors consistently improve outcomes across heart failure phenotypes, while glucagon-like peptide-1 receptor agonists offer benefits mainly in obesity-related HFpEF. By contrast, several older glucose-lowering drugs may worsen congestion or remain neutral in prognosis. The review concludes that diabetes and heart failure form a complex, self-reinforcing network, and that targeted treatment strategies grounded in mechanistic understanding are critical for advancing patient care and clinical outcomes.
Source: Theoretical and Natural Science
Author: Ruihan Ma
Institution: King's College London
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414452287
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