Рабочая группа по диабету, предиабету и сердечно-сосудистым заболеваниям европейского общества кардиологов (ESC) в сотрудничестве с европейской ассоциацией по изучению диабета (EASD).

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OBJECTIVE -Diabetes is an independent risk factor for heart failure, whereas the relation between heart failure and abnormal glucose regulation (AGR) needs further evaluation. We studied this combination in the Reykjavík Study. RESEARCH DESIGN AND METHODS -The ReykjavíkStudy, a population-based cohort study during 1967-1997, recruited 19,381 participants aged 33-84 years who were followed until 2002. Oral glucose tolerance tests and chest X-rays were obtained from all participants. Cases were defined in accordance with World Health Organization criteria for type 2 diabetes or AGR (impaired glucose tolerance or impaired fasting glucose) and European Society of Cardiology guidelines for heart failure.RESULTS -The overall prevalence of type 2 diabetes and heart failure was 0.5% in men and 0.4% in women, while AGR and heart failure were found in 0.7% of men and 0.6% of women. Among participants with normal glucose regulation, heart failure was diagnosed in 3.2% compared with 6.0 and 11.8% among those with AGR and type 2 diabetes, respectively. The prevalence of type 2 diabetes in the age-group 45-65 years increased in both sexes during the period (P for trend ϭ 0.007). The odds ratio was 2.8 (95% CI 2.2-3.6) for the association between type 2 diabetes and heart failure and 1.7 (1.4 -2.1) between AGR and heart failure.CONCLUSIONS -There is a strong association between any form of glucometabolic perturbation and heart failure. Future studies in this field should focus on all types of glucose abnormalities rather than previously diagnosed diabetes only. Diabetes Care 28:612-616, 2005T ype 2 diabetes, a disease of increasing prevalence, is a risk factor for heart failure (1,2). Poor glucometabolic control, as reflected by a high HbA 1c , increases the risk of developing heart failure (3). Diabetic patients are more prone to develop heart failure during an ischemic event, despite comparable size of myocardial injury, and their prognosis is more unfavorable than that in nondiabetic patients (4).The prevalence of heart failure combined with diabetes was 10 and 15%, respectively, among elderly Italians. Moreover, a higher proportion of patients with than without heart failure developed diabetes over time (5). Although there are reports on the relationship of either diabetes or impaired glucose tolerance and heart failure (6,7), the association of the total spectrum of glucose abnormalities and heart failure, as well as the prevalence and risk factors for heart failure, has, to our knowledge, not been studied in a large epidemiological study.The Reykjavík Study is a populationbased study that included glucose tolerance tests for almost every participant. The present study reports on the prevalence of glucose abnormalities and heart failure and their combination in this population. RESEARCH DESIGN AND METHODS -All inhabitants in theReykjavík metropolitan area at 1 December 1966 and born 1907-1935 were invited to participate in the study, as previously reported (8). Those who participated (n ϭ 19,381) were divided into groups ...

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Congestive heart failure (CHF) is a serious disease with a poor prognosis. Diabetes is an independent risk factor for CHF, probably in part due to disturbances in myocardial metabolism. Glucagon-like peptide-1 (GLP-1) causes glucose-dependent secretion of insulin, improving glycaemic control. In turn, this may improve myocardial metabolism and myocardial function. The aim of the present study was to assess the feasibility and safety of three days' infusion of recombinant GLP-1 in an open observational study in six patients with type 2 diabetes and CHF. The study included assessment of myocardial function. There were no major complications of the infusion, and all patients completed the study protocol. Some improvement was observed in glycaemic state, and there was an insignificant trend towards improved myocardial function. It is concluded that GLP-1 deserves further evaluation in such patients.