Expert consensus on the practical aspects of collaboration between cardiologists and diabetologists in the management of patients with chronic heart failure with reduced ejection fraction
Abstract
While diabetes mellitus per se is a major risk factor for heart failure, development of diabetes in patients with heart failure makes their prognosis even worse. A breakthrough in the treatment of heart failure came with the discovery of gliflozins, which, by blocking glucose reabsorption in the proximal tubule through the action of sodium-glucose co-transporter 2 inhibitors, lower blood glucose levels by inducing glycosuria.
Gliflozins have been and continue to be used primarily as efficient antidiabetic drugs, which, in addition to improving diabetes control, help reduce body weight and blood pressure while not raising the risk of hypoglycemia. Recent studies have shown that gliflozins in diabetic patients significantly reduce the risk of cardiovascular complications and hospitalization for heart failure.
Moreover, trials with dapagliflozin and empagliflozin conducted in recent years have demonstrated significant decreases in the composite endpoint of cardiovascular death and hospitalization for heart failure in patients with heart failure with reduced ejection fraction, both with and without diabetes. The aim of this article is to summarize, as an expert consensus document, practical aspects of collaboration of cardiologists and diabetologists in the management of patients with chronic heart failure with reduced ejection fraction in the context of current guidelines and other therapeutic options.