Chronic heart failure fosters the onset of type 2 diabetes mellitus




Gustavo A. Márquez-Salom, Departamento Médico, Centro de atención a personas con diabetes CAIAD, Sincelejo, Sucre, Colombia
Álvaro Márquez-Zuccardi, Departamento Médico, Centro de atención a personas con diabetes CAIAD, Sincelejo, Sucre, Colombia
Alejandro Márquez-Fernández, Departamento Médico, Centro de atención a personas con diabetes CAIAD, Sincelejo, Sucre, Colombia


Chronic heart failure (HF) fosters the onset of type 2 diabetes mellitus, and this is a little known and understood fact. The purpose of this article is to review the mechanisms that are activated in HF to induce the onset of type 2 diabetes mellitus, its cardio-metabolic implications, and the identified risk factors, as a necessary contribution to the scant available information in medical publications. Insulin resistance, inflammation, oxidative stress and systemic vasoconstriction are directly orchestrated by the heart in HF. The current treatment for heart failure with reduced ejection fraction (HFrEF), based on sodium-glucose transport protein 2 (SGLT2) inhibitors, angiotensin receptor-neprilysin inhibitors (ARNIs)/ACE inhibitors/ARBs and mineralocorticoid receptor antagonists, could have beneficial effects for preventing the onset of diabetes mellitus in patients with chronic HF, although the available evidence does not yet provide sufficient support, perhaps due to a lack of recognition of this problem.



Keywords: Heart failure. Insulin resistance. Inflammation. Oxidative stress. Diabetes mellitus Type 2. Visceral white adipose tissue.