The Failing Heart in Diabetes with Special Emphasis on Prevention

Diabetes and heart failure are emerging as twin epidemics with huge socioeconomic implications in patients across the globe. The situation is even abysmal considering the unique challenges faced by the health care sector in the lower-income countries with the growing size of the diabetes population (12.34% as reported by IDF 2019). Heart failure (HF) represents one of the most common yet less-recognized comorbidities of type 2 diabetes mellitus (T2DM). Besides, limited understanding of this multifactorial disease, together with a lack of effective therapeutics, has led to an underestimation of the risk in this population. However, until recently, the emerging classes have started to rekindle our efforts to understand this cardiometabolic conundrum once again due to the latest reports of their distinct therapeutic effects in the prevention of hospitalization of concomitant heart failure. Prevention of HF in patients with diabetes needs to be a priority for all caregivers as it is not only possible now to treat effectively but often rewarding from the patient's quality of life perspective in the long run. The present review is an attempt to summarize the current base of knowledge on the epidemiology, interrelationships of HF and T2DM and their shared pathophysiology, clinical correlates, and the current status of emerging novel therapies.

Keywords: Asian population, Heart failure, SGLT2 inhibitor, Type 2 diabetes.