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Cardiogenic diabetes

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Abstract

It has been well established since the Framingham studies that diabetes mellitus is a risk factor for heart failure. Several recent reports suggested that the reverse is also true, and heart failure may also predispose to diabetes. We reviewed the literature and summarized the evidence of a higher incidence of new-onset diabetes in heart failure. Because a high rate of insulin resistance in heart failure is a known phenomenon, a higher incidence of diabetes in heart failure is intuitive. Although the facts confirming such connection is surprisingly scarce, we felt it was important to collect, analyze, and summarize the evidence.

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References

  1. Massie BM, Shah NB (1997) Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management. Am Heart J 133:703–712

    Article  CAS  PubMed  Google Scholar 

  2. Nichols GA, Gullion CM, Koro CE, Ephross SA, Brown JB (2004) The incidence of congestive heart failure in type 2 diabetes: an update. Diabetes Care 27:1879–1884

    Article  PubMed  Google Scholar 

  3. Seshasai SR, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, Whincup PH, Mukamal KJ, Gillum RF, Holme I, Njolstad I, Fletcher A, Nilsson P, Lewington S, Collins R, Gudnason V, Thompson SG, Sattar N, Selvin E, Hu FB, Danesh J (2011) Diabetes mellitus, fasting glucose, and risk of cause-specific death. New Engl J Med 364:829–841

    Article  CAS  PubMed  Google Scholar 

  4. Smooke S, Horwich TB, Fonarow GC (2005) Insulin-treated diabetes is associated with a marked increase in mortality in patients with advanced heart failure. Am Heart J 149:168–174

    Article  CAS  PubMed  Google Scholar 

  5. Gustafsson I, Brendorp B, Seibaek M, Burchardt H, Hildebrandt P, Kober L, Torp-Pedersen C (2004) Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure. J Am Coll Cardiol 43:771–777

    Article  PubMed  Google Scholar 

  6. Kannel WB, Hjortland M, Castelli WP (1974) Role of diabetes in congestive heart failure: the framingham study. Am J Cardiol 34:29–34

    Article  CAS  PubMed  Google Scholar 

  7. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR (2000) Association of glycaemia with macro vascular and microvascular complications of type 2 diabetes (ukpds 35): prospective observational study. BMJ 321:405–412

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Held C, Gerstein HC, Yusuf S, Zhao F, Hilbrich L, Anderson C, Sleight P, Teo K (2007) Glucose levels predict hospitalization for congestive heart failure in patients at high cardiovascular risk. Circulation 115:1371–1375

    Article  CAS  PubMed  Google Scholar 

  9. Nichols GA, Moler EJ (2011) Cardiovascular disease, heart failure, chronic kidney disease and depression independently increase the risk of incident diabetes. Diabetology 54:523–526

    Article  CAS  Google Scholar 

  10. Uriel N, Naka Y, Colombo PC, Farr M, Pak SW, Cotarlan V, Albu JB, Gallagher D, Mancini D, Ginsberg HN, Jorde UP (2011) Improved diabetic control in advanced heart failure patients treated with left ventricular assist devices. Eur J Heart Fail 13:195–199

    Article  PubMed Central  PubMed  Google Scholar 

  11. Solang L, Malmberg K, Ryden L (1999) Diabetes mellitus and congestive heart failure. Further knowledge needed. Eur Heart J 20:789–795

    Article  CAS  PubMed  Google Scholar 

  12. Amato L, Paolisso G, Cacciatore F, Ferrara N, Ferrara P, Canonico S, Varricchio M, Rengo F (1997) Congestive heart failure predicts the development of non-insulin-dependent diabetes mellitus in the elderly. The osservatorio geriatrico regione campania group. Diabetes Metab 23:213–218

    CAS  PubMed  Google Scholar 

  13. Bobbio M, Ferrua S, Opasich C, Porcu M, Lucci D, Scherillo M, Tavazzi L, Maggioni AP (2003) Survival and hospitalization in heart failure patients with or without diabetes treated with beta-blockers. J Card Fail 9:192–202

    Article  CAS  PubMed  Google Scholar 

  14. Suskin N, McKelvie RS, Burns RJ, Latini R, Pericak D, Probstfield J, Rouleau JL, Sigouin C, Solymoss CB, Tsuyuki R, White M, Yusuf S (2000) Glucose and insulin abnormalities relate to functional capacity in patients with congestive heart failure. Eur Heart J 21:1368–1375

    Article  CAS  PubMed  Google Scholar 

  15. Vermes E, Ducharme A, Bourassa MG, Lessard M, White M, Tardif JC (2003) Enalapril reduces the incidence of diabetes in patients with chronic heart failure: insight from the studies of left ventricular dysfunction (solvd). Circulation 107:1291–1296

    Article  CAS  PubMed  Google Scholar 

  16. Andersson B, Waagstein F (1993) Spectrum and outcome of congestive heart failure in a hospitalized population. Am Heart J 126:632–640

    Article  CAS  PubMed  Google Scholar 

  17. From AM, Leibson CL, Bursi F, Redfield MM, Weston SA, Jacobsen SJ, Rodeheffer RJ, Roger VL (2006) Diabetes in heart failure: prevalence and impact on outcome in the population. Am J Med 119:591–599

    Article  PubMed  Google Scholar 

  18. Romero SP, Garcia-Egido A, Escobar MA, Andrey JL, Corzo R, Perez V, Garcia-Domiguez GJ, Gomez F (2012) Impact of new-onset diabetes mellitus and glycemic control on the prognosis of heart failure patients: a propensity-matched study in the community. Int J Cardiol

  19. Gerstein HC, Swedberg K, Carlsson J, McMurray JJ, Michelson EL, Olofsson B, Pfeffer MA, Yusuf S (2008) The hemoglobin a1c level as a progressive risk factor for cardiovascular death, hospitalization for heart failure, or death in patients with chronic heart failure: an analysis of the candesartan in heart failure: Assessment of reduction in mortality and morbidity (charm) program. Arch Intern Med 168:1699–1704

    Article  CAS  PubMed  Google Scholar 

  20. Issa VS, Amaral AF, Cruz FD, Ayub-Ferreira SM, Guimaraes GV, Chizzola PR, Souza GE, Bocchi EA (2010) Glycemia and prognosis of patients with chronic heart failure–sub analysis of the long-term prospective randomized controlled study using repetitive education at 6-month intervals and monitoring for adherence in heart failure outpatients (remade) trial. Am Heart J 159:90–97

    Article  PubMed  Google Scholar 

  21. Eshaghian S, Horwich TB, Fonarow GC (2006) An unexpected inverse relationship between hba1c levels and mortality in patients with diabetes and advanced systolic heart failure. Am Heart J 151:91

    Article  PubMed  Google Scholar 

  22. Tomova GS, Nimbal V, Horwich TB (2012) Relation between hemoglobin a(1c) and outcomes in heart failure patients with and without diabetes mellitus. Am J Cardiol 109:1767–1773

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Aguilar D, Bozkurt B, Ramasubbu K, Deswal A (2009) Relationship of hemoglobin a1c and mortality in heart failure patients with diabetes. J Am Coll Cardiol 54:422–428

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Andersson C, Norgaard ML, Hansen PR, Fosbol EL, Schmiegelow M, Weeke P, Olesen JB, Raunso J, Jorgensen CH, Vaag A, Kober L, Torp-Pedersen C, Gislason GH (2010) Heart failure severity, as determined by loop diuretic dosages, predicts the risk of developing diabetes after myocardial infarction: a nationwide cohort study. Eur J Heart Fail 12:1333–1338

    Article  CAS  PubMed  Google Scholar 

  25. Yusuf S, Ostergren JB, Gerstein HC, Pfeffer MA, Swedberg K, Granger CB, Olofsson B, Probstfield J, McMurray JV (2005) Effects of candesartan on the development of a new diagnosis of diabetes mellitus in patients with heart failure. Circulation 112:48–53

    Article  CAS  PubMed  Google Scholar 

  26. Andraws R, Brown DL (2007) Effect of inhibition of the renin-angiotensin system on development of type 2 diabetes mellitus (meta-analysis of randomized trials). Am J Cardiol 99:1006–1012

    Article  CAS  PubMed  Google Scholar 

  27. Bosch J, Yusuf S, Gerstein HC, Pogue J, Sheridan P, Dagenais G, Diaz R, Avezum A, Lanas F, Probstfield J, Fodor G, Holman RR (2006) Effect of ramipril on the incidence of diabetes. New Engl J Med 355:1551–1562

    Article  PubMed  Google Scholar 

  28. Torp-Pedersen C, Metra M, Charlesworth A, Spark P, Lukas MA, Poole-Wilson PA, Swedberg K, Cleland JG, Di Lenarda A, Remme WJ, Scherhag A (2007) Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: data from the carvedilol or metoprolol European trial (comet). Heart 93:968–973

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Preiss D, van Veldhuisen DJ, Sattar N, Krum H, Swedberg K, Shi H, Vincent J, Pocock SJ, Pitt B, Zannad F, McMurray JJ (2012) Eplerenone and new-onset diabetes in patients with mild heart failure: results from the eplerenone in mild patient’s hospitalization and survival study in heart failure (emphasis-hf). Eur J Heart Fail 14:909–915

    Article  CAS  PubMed  Google Scholar 

  30. Newton JD, Squire IB (2006) Glucose and haemoglobin in the assessment of prognosis after first hospitalisation for heart failure. Heart 92:1441–1446

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Barsheshet A, Garty M, Grossman E, Sandach A, Lewis BS, Gottlieb S, Shotan A, Behar S, Caspi A, Schwartz R, Tenenbaum A, Leor J (2006) Admission blood glucose level and mortality among hospitalized nondiabetic patients with heart failure. Arch Intern Med 166:1613–1619

    Article  PubMed  Google Scholar 

  32. Tenenbaum A, Motro M, Fisman EZ, Leor J, Freimark D, Boyko V, Mandelzweig L, Adler Y, Sherer Y, Behar S (2003) Functional class in patients with heart failure is associated with the development of diabetes. Am J Med 114:271–275

    Article  PubMed  Google Scholar 

  33. Witteles RM, Tang WH, Jamali AH, Chu JW, Reaven GM, Fowler MB (2004) Insulin resistance in idiopathic dilated cardiomyopathy: a possible etiologic link. J Am Coll Cardiol 44:78–81

    Article  CAS  PubMed  Google Scholar 

  34. Egstrup M, Kistorp CN, Schou M, Hofsten DE, Moller JE, Tuxen CD, Gustafsson I (2012) Abnormal glucose metabolism is associated with reduced left ventricular contractile reserve and exercise intolerance in patients with chronic heart failure. Eur Heart J Cardiovasc Imaging

  35. Aldasouqi SA, Logue WJ (2000) The batista procedure significantly improved cardiac function and glycemic control in a diabetic patient with severe insulin resistance. Diabetes Care 23:255–256

    Article  CAS  PubMed  Google Scholar 

  36. Wong AK, AlZadjali MA, Choy AM, Lang CC (2008) Insulin resistance: a potential new target for therapy in patients with heart failure. Cardiovasc Ther 26:203–213

    Article  CAS  PubMed  Google Scholar 

  37. Ingelsson E, Sundstrom J, Arnlov J, Zethelius B, Lind L (2005) Insulin resistance and risk of congestive heart failure. JAMA 294:334–341

    Article  CAS  PubMed  Google Scholar 

  38. Swan JW, Walton C, Godsland IF, Clark AL, Coats AJ, Oliver MF (1994) Insulin resistance in chronic heart failure. Eur Heart J 15:1528–1532

    CAS  PubMed  Google Scholar 

  39. Paolisso G, De Riu S, Marrazzo G, Verza M, Varricchio M, D’Onofrio F (1991) Insulin resistance and hyperinsulinemia in patients with chronic congestive heart failure. Metabolism 40:972–977

    Article  CAS  PubMed  Google Scholar 

  40. Heck PM, Dutka DP (2009) Insulin resistance and heart failure. Curr Heart Fail Rep 6:89–94

    Article  CAS  PubMed  Google Scholar 

  41. Chokshi A, Drosatos K, Cheema FH, Ji R, Khawaja T, Yu S, Kato T, Khan R, Takayama H, Knoll R, Milting H, Chung CS, Jorde U, Naka Y, Mancini DM, Goldberg IJ, Schulze PC (2012) Ventricular assist device implantation corrects myocardial lipotoxicity, reverses insulin resistance, and normalizes cardiac metabolism in patients with advanced heart failure. Circulation 125:2844–2853

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Nikolaidis LA, Sturzu A, Stolarski C, Elahi D, Shen YT, Shannon RP (2004) The development of myocardial insulin resistance in conscious dogs with advanced dilated cardiomyopathy. Cardiovasc Res 61:297–306

    Article  CAS  PubMed  Google Scholar 

  43. AlZadjali MA, Godfrey V, Khan F, Choy A, Doney AS, Wong AK, Petrie JR, Struthers AD, Lang CC (2009) Insulin resistance is highly prevalent and is associated with reduced exercise tolerance in nondiabetic patients with heart failure. J Am Coll Cardiol 53:747–753

    Article  CAS  PubMed  Google Scholar 

  44. Doehner W, Rauchhaus M, Ponikowski P, Godsland IF, von Haehling S, Okonko DO, Leyva F, Proudler AJ, Coats AJ, Anker SD (2005) Impaired insulin sensitivity as an independent risk factor for mortality in patients with stable chronic heart failure. J Am Coll Cardiol 46:1019–1026

    Article  CAS  PubMed  Google Scholar 

  45. Coats AJ, Anker SD (2000) Insulin resistance in chronic heart failure. J Cardiovasc Pharmacol 35:S9–S14

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Maya Guglin.

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Guglin, M., Villafranca, A. & Morrison, A. Cardiogenic diabetes. Heart Fail Rev 19, 595–602 (2014). https://doi.org/10.1007/s10741-013-9412-9

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