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Educational videos about Heart Failure as a complication of diabetes with patient case

Introduction E. Cosson and C. Meune
Management of HF as a complication of diabetes explained from the perspective of a cardiologist and a diabetologist

In this series of videos, Christophe Meune, Professor of Cardiology, and Emmanuel Cosson, Professor of Diabetology, discuss HF as a complication of T2D, HF and CV screening and risk stratification, treatment of HF in patients with T2D, the importance of collaboration between cardiology and diabetology and a patient case study.

As patients with both Type 1 and Type 2 diabetes are at an increased risk of developing HF,1 it is extremely important that cardiologists and endocrinologists or diabetologists closely collaborate to effectively manage these patients. Professor Meune and Professor Cosson emphasise the need to screen for HF all patients with diabetes as early as possible to prevent the development and progression of HF.

T2D and Heart Failure

Professors Meune and Cosson outline the recently established CV risk assessment method for patients with diabetes from the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). They highlight the value of NT-proBNP as a first-line screening tool for identifying high-risk individuals.7

HF risk assessment

When it comes to treating HF in patients with diabetes, it is important to consider which pharmacological treatments are appropriate as some diabetes treatments may increase the risk of HF.8 Professor Meune and Professor Cosson share the guideline-recommended therapies and key considerations when managing these patients.

HF treatment in T2D

In their final video of the series, Professor Meune and Professor Cosson share the case of a 69-year-old diabetes patient with obesity, dyslipidaemia, controlled hypertension and non-acute breathlessness. Through the description of the case, they emphasise the value of continued monitoring, multidisciplinary collaboration between cardiologists and endocrinologists or diabetologists, as well as the importance of adapting the therapy by considering the effects of the different treatments on the comorbidities.

Patient case

Key facts

  • Heart failure (HF) is one of the most prevalent cardiovascular (CV) complications in patients with diabetes.1 Diabetes patients with HF often have a poorer prognosis than non-diabetic HF patients, with higher rates of hospitalisation and mortality.2 
  • Early identification, through screening initiatives, of Type 2 Diabetes (T2D) patients at risk of developing HF, along with improved risk stratification strategies, such as NT-proBNP screening, are key to enabling appropriate management to prevent adverse outcomes.3
  • Effective cardioprotective therapies for HF are available for patients with and without diabetes and are recommended by international guidelines. These therapies have been shown to significantly reduce hospitalisation and mortality.3,4,5,6
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    References

    1. McMurray JJ, et al. Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. Lancet Diabetes Endocrinol. 2014;2(10):843-51.  
    2. Burrows NR et al. Declining Rates of Hospitalization for Selected Cardiovascular Disease Conditions Among Adults Aged ≥35 Years With Diagnosed Diabetes, U.S., 1998-2014. Diabetes Care. 2018;41(2):293-302.
    3. Pop-Busui et al. Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association Diabetes Care 2022. 2022;45:1670-90.
    4. UK National Health Service. Heart failure treatment. [Internet; cited 2022 December] Available from: https://www.nhs.uk/conditions/heart-failure/treatment/.
    5. Heidenreich PA, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895–e1032.
    6. McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2021;42(36):3599-726.
    7. Cosentino F, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323.
    8. Fitchett DH, et al. Heart failure outcomes in clinical trials of glucose-lowering agents in patients with diabetes. Eur J Heart Fail. 2017;19:43-53.