Diabetes and heart failure often go hand in hand -

Diabetes increases the risk of heart failure and vice versa

In a joint statement, two leading German specialist companies explain the link between heart failure (heart failure) and diabetes. Experts warn that anyone with one of the two underlying conditions also has an increased risk of developing the other condition.

Experts from the German Diabetes Society (DDG) and the German Cardiological Society (DGK) have published a first joint position paper in which the links between diabetes and heart failure are clarified.

Often the two diseases are present together

Specialist companies refer to studies that have shown that almost a third of people with diabetes also suffer from heart failure. Conversely, heart failure is associated with lower metabolism, which means that 30-40% of all patients with heart failure develop prediabetes or overt type 2 diabetes.

The position paper aims, among other things, to make physicians aware of the link between clinical pictures. Affected individuals should be regularly examined for both diseases.

Deadly interaction between diabetes and heart failure

“Diabetes mellitus and heart failure often go hand in hand, often underestimated and sometimes fatal,” confirms medical professor Dr. Thomas Forêt. He is the first president of the “Diabetes & Heart” working group of the DDG.

According to him, people who suffer from both diseases have a 50 to 90% increased risk of mortality from cardiovascular events.

Better cooperation between diabetes and cardiology

“It is all the more important to identify these high-risk patients early and to improve their life expectancy thanks to a differentiated therapy”, underlines the professor.

In the first joint position paper of the two professional societies, the current scientific data on the two clinical pictures are summarized. In addition, recommendations for diabetologists and cardiologists have been formulated on what to consider in diagnosis and therapy.

High number of unreported cases

According to experts, diastolic heart failure (HFpEF) is often clinically trivial. "It can therefore be assumed that the diagnosis of this form of heart failure in people with diabetes is made far too rarely and that there are a high number of unreported cases of people who already have the condition", emphasizes medical Dr. Katharina Schütt, the first author of the position paper.

"If the affected person is symptomatic, such dysfunction can be detected through echocardiography," says Dr. Gross.

In the case of diabetes, doctors therefore recommend that those affected regularly inquire about the symptoms of heart failure. Conversely, people with heart failure should also be checked for signs of diabetes due to their significantly increased risk of type 2 diabetes.

"Here, too, we urgently recommend regular diabetes screenings, in which the glucose and HbA1c value is measured and, if necessary, the OGTT is also determined", adds Prof. Dr. Medical Dirk Müller-Wieland of the DDG.

Why are diabetes and heart failure linked?

As professional societies explain, the close link between heart failure and diabetes can be explained by an overall metabolic disorder, including deterioration of arterial and coronary status.

Permanently high blood sugar levels (HbA1c), for example, lead to chronic inflammatory processes in the vessels. The heart is initially not limited in its pumping ability, but the inflammation causes the vessel walls to become stiff, which means the heart can no longer fill with enough blood.

If heart failure is present first, it promotes diabetic processes that increase glucose metabolism and cause insulin resistance.

Heart failure often ends in death

"In the event of heart failure, one in five people affected does not survive twelve months after the first hospitalization", warns cardiologist Schütt. According to her, if heart failure is diagnosed too late or underestimated, it is often fatal. (vb)

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This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.


Graduate editor (FH) Volker Blasek


DDG and DKG Position Paper: Heart Failure and Diabetes (from 2022), ddg.infoDDG and DGK Report Deadly Interaction and Too Rare Diagnoses of Diseases (Published: Aug 11, 2022), ddg.info

Important Note:
This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.