Abstract
Type 2 diabetes mellitus is associated with a substantial increase in the risk of development of heart failure. The mechanisms causing this complication are complex and include coronary heart disease, myocardial changes induced by hypertension, increased aortic stiffness, arrhythmias, renal failure and last but not least by direct metabolic alterations causing diabetic cardiomyopathy.
The heart failure could be induced by several drugs used for diabetes therapy. This review debates the current evidence of harms and benefits of diabetes treatment related to heart failure in the light of results of recent randomized trials.
An increased risk of heart failure was reported with sulphonylureas, glizatones and some DPP4 inhibitors. In contrast a considerable risk reduction was demonstrated in the EMPA-REG OUTCOME trial using empagliflozin.