Heart failure in diabetes: effects of anti-hyperglycemic drug therapy

Studies on the cardiovascular safety of new anti-diabetic drugs have drawn attention to the problem of heart failure (HF) in patients with type 2 diabetes mellitus (T2DM). This has included one controversial study about hospitalization associated with HF in patients treated with dipeptidyl-peptidase-4 inhibitors (I-DPP4) compared with placebo. Until recently, HF was not considered to be a vascular or chronic complication of diabetes. It is well known that patients with T2DM generally have a higher risk of developing HF. In addition, the mortality risk of patients with HF and diabetes is significantly higher than that among patients with HF without carbohydrate metabolism disorders. Among patients with HF, hyperglycaemia requiring anti-diabetic therapy is much more common than among patients without HF. Therefore, it is important to address this issue in terms of the pathogenesis of HF in patients with T2DM, the influence and dynamics of glycaemic control and methods to achieve glycaemic control, including the selection of various types of anti-diabetic drugs.