Diabetes, Cardiomyopathy, And Heart Failure-An Updated Review Article for Nursing.

Abstract

Background: Diabetes has been recognized as a significant risk factor for heart failure (HF) and cardiomyopathy. Its impact extends beyond the traditional cardiovascular (CV) risk factors such as hypertension and coronary artery disease (CAD). Diabetes contributes to heart failure through various mechanisms, including insulin resistance, altered myocardial metabolism, and inflammatory pathways. As a result, individuals with diabetes are categorized as at risk for HF, with prevalence rates significantly higher in diabetic populations compared to the general population. Recent advancements in understanding the pathophysiology of diabetes-related heart failure have led to new treatment strategies, particularly involving sodium-glucose co-transporter-2 (SGLT2) inhibitors.

Aim:The aim of this review is to examine the relationship between diabetes, cardiomyopathy, and heart failure, with a focus on pathophysiology, diagnosis, prognostic implications, Nursing intervention plans, and management strategies.

Methods: This article provides a comprehensive review of current literature regarding the prevalence, pathophysiology, and treatment of diabetes-related heart failure. It integrates findings from epidemiological studies, clinical trials, and advances in pharmacotherapy, particularly SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Additionally, the article discusses the importance of early detection and classification of heart failure phenotypes in diabetic patients.

Results: Diabetes and heart failure are often coexistent, with diabetes increasing the risk of developing heart failure by 1.7 to 2.5 times. The prevalence of heart failure in diabetic patients varies between 9% and 22%, and recent trials have shown that SGLT2 inhibitors significantly improve outcomes for both diabetic and non-diabetic patients with heart failure. Moreover, glycemic control remains an important factor in reducing the risk of heart failure hospitalizations.

Conclusion: The coexistence of diabetes and heart failure significantly worsens prognosis, highlighting the need for early screening and intervention. New pharmacological treatments such as SGLT2 inhibitors offer promising outcomes for patients with both conditions. Early detection of pre-diabetes and diabetes in individuals with heart failure is crucial for improving patient outcomes and reducing the risk of cardiovascular morbidity and mortality.