Heart failure in type 2 diabetes: current perspectives on screening, diagnosis and management

Ceriello, Antonio; Catrinoiu, Doina; Chandramouli, Chanchal; Cosentino, Francesco; Dombrowsky, Annique Cornelia; Itzhak, Baruch; Lalić, Nebojša; Prattichizzo, Francesco; Schnell, Oliver; Seferović, Petar; Valensi, P.; Standl, Eberhard

doi:10.1186/s12933-021-01408-1

Cited by 62 publications

(63 citation statements)

References 156 publications

(263 reference statements)

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“…The CArdioREnal and MEtabolic disease (CaReMe) cardiorenal study is a multinational, observational, descriptive study that utilized the unique features of available healthcare registries and the corresponding healthcare systems' secondary data from 12 countries across North America, Asia, and Europe: Belgium, Canada, England, Germany, Israel, Italy, Japan, The Netherlands, Norway, Portugal, Spain, and Sweden (Figure 1; supporting information, pages [4][5][6][7][8][9][10][11]. A heat map describing the coverage of the registries and the availability of data is illustrated in Figure S1.…”

Section: Methodsmentioning

confidence: 99%

Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries

Norhammar

Bodegård²,

Eriksson

et al. 2022

Diabetes Obesity Metabolism

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Aim To examine how the development of cardiovascular and renal disease (CVRD) translates to hospital healthcare costs in individuals with type 2 diabetes (T2D) initially free from CVRD. Methods Data were obtained from the digital healthcare systems of 12 nations using a prespecified protocol. A fixed country‐specific index date of 1 January was chosen to secure sufficient cohort disease history and maximal follow‐up, varying between each nation from 2006 to 2017. At index, all individuals were free from any diagnoses of CVRD (including heart failure [HF], chronic kidney disease [CKD], coronary ischaemic disease, stroke, myocardial infarction [MI], or peripheral artery disease [PAD]). Outcomes during follow‐up were hospital visits for CKD, HF, MI, stroke, and PAD. Hospital healthcare costs obtained from six countries, representing 68% of the total study population, were cumulatively summarized for CVRD events occurring during follow‐up. Results In total, 1.2 million CVRD‐free individuals with T2D were identified and followed for 4.5 years (mean), that is, 4.9 million patient‐years. The proportion of individuals indexed before 2010 was 18% (n = 207 137); 2010‐2015, 31% (361 175); and after 2015, 52% (609 095). Overall, 184 420 (15.7%) developed CVRD, of which cardiorenal disease was most frequently the first disease to develop (59.7%), consisting of 23.0% HF and 36.7% CKD, and more common than stroke (16.9%), MI (13.7%), and PAD (9.7%). The total cumulative cost for CVRD was US$1 billion, of which 59.0% was attributed to cardiorenal disease, 3‐, 5‐, and 6‐fold times greater than the costs for stroke, MI, and PAD, respectively. Conclusion Across all nations, HF or CKD was the most frequent CVRD manifestation to develop in a low‐risk population with T2D, accounting for the highest proportion of hospital healthcare costs. These novel findings highlight the importance of cardiorenal awareness when planning healthcare.

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Section: Methodsmentioning

confidence: 99%

Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries

Norhammar

Bodegård²,

Eriksson

et al. 2022

Diabetes Obesity Metabolism

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“…These can be alleviated through careful and continuous blood glucose control. Micro-and macrovascular damage occurs at the arterial level, causing cardiovascular and cerebrovascular diseases that can result in cardiac infarction and stroke [2,3]. In the condition of chronic hyperglycemia, glucose tends to form covalent adducts with plasma proteins (albumin, fibrinogen, globulins, collagen) through a nonenzymatic process known as glycation [1,4].…”

Section: Introductionmentioning

confidence: 99%

Anti-α-Glucosidase and Antiglycation Activities of α-Mangostin and New Xanthenone Derivatives: Enzymatic Kinetics and Mechanistic Insights through In Vitro Studies

et al. 2022

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Diabetes mellitus is characterized by chronic hyperglycemia that promotes ROS formation, causing severe oxidative stress. Furthermore, prolonged hyperglycemia leads to glycation reactions with formation of AGEs that contribute to a chronic inflammatory state. This research aims to evaluate the inhibitory activity of α-mangostin and four synthetic xanthenone derivatives against glycation and oxidative processes and on α-glucosidase, an intestinal hydrolase that catalyzes the cleavage of oligosaccharides into glucose molecules, promoting the postprandial glycemic peak. Antiglycation activity was evaluated using the BSA assay, while antioxidant capacity was detected with the ORAC assay. The inhibition of α-glucosidase activity was studied with multispectroscopic methods along with inhibitory kinetic analysis. α-Mangostin and synthetic compounds at 25 µM reduced the production of AGEs, whereas the α-glucosidase activity was inhibited only by the natural compound. α-Mangostin decreased enzymatic activity in a concentration-dependent manner in the micromolar range by a reversible mixed-type antagonism. Circular dichroism revealed a rearrangement of the secondary structure of α-glucosidase with an increase in the contents of α-helix and random coils and a decrease in β-sheet and β-turn components. The data highlighted the anti-α-glucosidase activity of α-mangostin together with its protective effects on protein glycation and oxidation damage.

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“…However, the glycemic alterations induced by IR, ranging from mild dysglycaemia to diabetes, may conversely increase the risk of HF and HF progression [ 5 , 7 ]. How IR develops and worsens in HF patients is not well-understood, but IR may derive from many factors: enhanced sympathetic activation, loss of skeletal muscle mass, endothelial dysfunction, forced sedentary lifestyle due to reduced cardiac output and increased fatigability, a potential effect of increased circulating cytokines, and molecular mechanisms [ 6 , 35 – 42 ]. The main mechanism involves probably ‘neurohormone hypothesis’ [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of patients with both HF and diabetes keeps increasing as the population is ageing [ 5 ] and diabetes is among the most common co-morbidities in HF patients, potentially increasing the risk of hospitalization and death [ 5 ]. Interestingly, HF with preserved ejection fraction (HFpEF) is currently the most frequent form of HF [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prediabetes and insulin resistance in a population of patients with heart failure and reduced or preserved ejection fraction but without diabetes, overweight or hypertension

Son

Toan

Thang

et al. 2022

Cardiovasc Diabetol

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Background The relationships between glucose abnormalities, insulin resistance (IR) and heart failure (HF) are unclear, especially regarding to the HF type, i.e., HF with reduced (HFrEF) or preserved (HFpEF) ejection fraction. Overweight, diabetes and hypertension are potential contributors to IR in persons with HF. This study aimed to evaluate the prevalence of prediabetes and IR in a population of Vietnamese patients with HFrEF or HFpEF but no overweight, diabetes or hypertension, in comparison with healthy controls, and the relation between prediabetes or IR and HF severity. Methods We conducted a prospective cross-sectional observational study in 190 non-overweight normotensive HF patients (114 with HFrEF and 76 with HFpEF, 92.6% were ischemic HF, mean age was 70.1 years, mean BMI 19.7 kg/m2) without diabetes (neither known diabetes nor newly diagnosed by OGTT) and 95 healthy individuals (controls). Prediabetes was defined using 2006 WHO criteria. Glucose and insulin levels were measured fasting and 2 h after glucose challenge. IR was assessed using HOMA-IR and several other indexes. Results Compared to controls, HF patients had a higher prevalence of prediabetes (63.2% vs 22.1%) and IR (according to HOMA-IR, 55.3% vs 26.3%), higher HOMA-IR, insulin/glucose ratio after glucose and FIRI, and lower ISIT0 and ISIT120 (< 0.0001 for all comparisons), with no difference for body weight, waist circumference, blood pressure and lipid parameters. Prediabetes was more prevalent (69.3% vs 53.9%, p = 0.03) and HOMA-IR was higher (p < 0.0001) in patients with HFrEF than with HFpEF. Among both HFrEF and HFpEF patients, those with prediabetes or IR had a more severe HF (higher NYHA functional class and NT-proBNP levels, lower ejection fraction; p = 0.04–< 0.0001) than their normoglycemic or non-insulinresistant counterparts, with no difference for blood pressure and lipid parameters. Conclusion In non-diabetic non-overweight normotensive patients with HF, the prevalence of prediabetes is higher with some trend to more severe IR in those with HFrEF than in those with HFpEF. Both prediabetes and IR are associated with a more severe HF. The present data support HF as a culprit for IR. Intervention strategies should be proposed to HF patients with prediabetes aiming to reduce the risk of incident diabetes. Studies should be designed to test whether such strategies may translate into an improvement of further HF-related outcomes.

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Heart failure in type 2 diabetes: current perspectives on screening, diagnosis and management

Cited by 62 publications

References 156 publications

Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries

Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries

Anti-α-Glucosidase and Antiglycation Activities of α-Mangostin and New Xanthenone Derivatives: Enzymatic Kinetics and Mechanistic Insights through In Vitro Studies

Prediabetes and insulin resistance in a population of patients with heart failure and reduced or preserved ejection fraction but without diabetes, overweight or hypertension

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