Several trials looking at the combination of diabetes and heart failure have been reviewed as part of an article which will be published in Current Diabetes Reports.
The number of people with heart failure and other serious conditions, such as diabetes, is on the rise and it is thought that those with both conditions have poor clinical outcomes when compared with diabetes patients who don’t have heart failure.
People with diabetes can reduce their risk of heart complications by making good lifestyle choices, such as eating a healthy diet and getting regular exercise. Moreover, keeping good control of blood sugar levels is beneficial for heart health.
After reviewing the ASTRONAUT (aliskiren) and EVEREST (tolvaptan) studies, hospitalization and mortality followed a U-shaped curve from low to high HbA1c values, with a summary of three trials finding that mortality is lowest for patients with HbA1c values between 7.5% (58.5 mmol/mol) and 8% (63.9 mmol/mol).
Larger trials looking at the effect of intensive glycemic control on heart failure were inconclusive. This was because there were low rates of heart failure patients within the participating people on the study.
But researchers did find a link between hypoglycemia and those who were admitted for hospital and mortality.
Positive findings for metformin have also been found with a retrospective analysis of those with heart failure and diabetes suggesting that those using the drug were less likely to die from heart-related issues, than people who did not use metformin.
The researchers added that healthcare professionals should not avoid using metformin in patients with diabetes and heart failure unless they are at risk for acute decompensated heart failure or lactic acidosis.
Additionally, the LEADER trial found liraglutide reduced cardiovascular mortality without any negative impact on heart failure, while the EMPA-REG CV outcome trial found empagliflozin decreased heart failure-related hospitalization and mortality in high-risk patients.

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