Congestive heart failure in patients with diabetes – therapeutic controversies

Leszek Czupryniak; Elektra Szymańska-Garbacz; Małgorzata Saryusz-Wolska

ISSN: 1505-8409

Przewodnik Lekarza/Guide for GPs

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4/2007
vol. 10

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abstract:

Congestive heart failure in patients with diabetes – therapeutic controversies

Leszek Czupryniak

,

Elektra Szymańska-Garbacz

,

Małgorzata Saryusz-Wolska

Przew Lek 2007; 4: 92-99

Online publish date: 2007/07/09

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Congestive heart failure (CHF) is found in 10-15% of diabetes patients, and 30-50% of subjects with CHF are treated for diabetes. Diabetes, with hypertension, hyperlipidaemia and ischaemic heart disease as frequent comorbidities, exerts damaging effects on myocardial structure and function. Excessive free fatty acids uptake and oxidation and endothelial dysfunction seem to play a major role in decreased heart function in diabetes. CHF treatment strategy in diabetes includes blood glucose normalization, myocardial blood flow improvement and drug therapy with diuretics, renin-angiotensin-aldosteron axis inhibitors, b-blockers and – in a few cases – digitalis preparations. Recent studies show that modest CHF should not be considered a contraindication to the use of certain anti-diabetic agents (e.g. metformin); it seems that not offering this treatment option to diabetic patients with CHF may unfavourably affect their morbidity and mortality.

keywords:

Congestive heart failure in patients with diabetes – therapeutic controversies

Leszek Czupryniak , Elektra Szymańska-Garbacz , Małgorzata Saryusz-Wolska

diabetes mellitus, congestive heart failure, diuretics, metformin, renin-angiotensin-aldosteron axis, thiazolidinedions

Leszek Czupryniak

,

Elektra Szymańska-Garbacz

,

Małgorzata Saryusz-Wolska