Diabetes mellitus and heart failure: insights from a toxic relationship

112 PRACTICAL DIABETES VOL. 35 NO. 4 COPYRIGHT © 2018 JOHN WILEY & SONS Heart failure (HF) and diabetes mellitus are often labelled the ‘deadly duo’ as patients with existing HF and concomitant diabetes mellitus have a significantly adverse prognosis.1 While these conditions frequently coexist, each are independently correlated with a higher risk of death.2–4 Diabetes mellitus is also one of the major risk factors that directly contributes to the development of HF.5 As the absolute numbers of people diagnosed with diabetes mellitus have quadrupled over the last four decades to 425 million worldwide, the prevalence of HF is therefore likely to rise.6 This article describes the rising incidence of heart failure in patients with diabetes and the factors that underpin this trend. It highlights the importance of identifying HF patients at risk of developing diabetes mellitus and the need to screen for diabetes mellitus in patients with HF. Furthermore, it summarises the current knowledge on disease pathophysiology and disease progression in HF in both type 1 (T1DM) and type 2 diabetes mellitus (T2DM).