LATER MIGHT BE TOO LATE: CONSIDER THE THREAT OF HEART FAILURE EARLIER IN THE T2D JOURNEY.
A quick look at a few key statistics paint a clear picture of the degree to which patients with type 2 diabetes are at an increased risk for heart failure, compared to those without T2D.1
THIS RISK OF HEART FAILURE STARTS EARLIER THAN YOU MIGHT SUSPECT IN YOUR PATIENTS WITH T2D2
For patients with T2D, heart failure is a more common first CV complication than myocardial infarction (MI) or stroke.3
of patients with T2D may develop heart failure2†
In fact, 68% of people with T2D showed signs of left ventricular (LV) dysfunction within 5 years of a diabetes diagnosis in the absence of inducible ischemia2‡
Even patients with prediabetes show evidence of heart damage that may be associated with heart failure5§
YET, AMONG PATIENTS WITH T2D, THERE IS A HIGH PREVALENCE OF UNDIAGNOSED HEART FAILURE6
In one study,
28% of patients with T2D were found to have previously undiagnosed heart failure6||
1. Nichols GA, Hillier TA, Erbey JR, et al. Congestive heart failure in type 2 diabetes: prevalence, incidence, and risk factors. Diabetes Care. 2001;24(9):1614-1619. 2. Faden G, Faganello G, De Feo S, et al. The increasing detection of asymptomatic left ventricular dysfunction in patients with type 2 diabetes mellitus without overt cardiac disease: data from the SHORTWAVE study. Diabetes Res Clin Pract. 2013;101(3):309-316. 3. Shah AD, Langenberg C, Rapsomaniki E, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1.9 million people. Lancet Diabetes Endocrinol. 2015;3(2)(suppl):105-113. 4. American Diabetes Association. 10. Cardiovascular disease and risk management: standards of medical care in diabetes—2019. Diabetes Care. 2019;42(suppl 1):S103-S123. 5. Selvin E, Lazo M, Chen Y, et al. Diabetes mellitus, prediabetes, and incidence of subclinical myocardial damage. Circulation. 2014;130:1374-1382. 6. Boonman-de Winter LJM, Rutten FH, Cramer MJM, et al. High prevalence of previously unknown heart failure and left ventricular dysfunction in patients with type 2 diabetes. Diabetologia. 2012;55:2154-2162.
MEASURING THE TOLL: THE IMPACT OF HEART FAILURE IN TYPE 2 DIABETES (T2D)
With the increased risk for heart failure, patients with type 2 diabetes mellitus also face a statistically greater risk for related hospitalization1 and death.2
INCREASED RISKS FOR HOSPITALIZATION, MEDICAL COSTS, AND READMISSION
Patients with T2D have a 33%
higher chance of
hospitalization for heart failure
than those without T2D1*
On average, the cost of heart failure-related hospitalization was approximately $23,0003†
Heart failure is the most frequent diagnosis associated with a 30-day readmission4
ONCE HEART FAILURE IS DIAGNOSED, THE PROGNOSIS IS GRIM
Cardiac function progressively worsens over time after acute heart failure events.5
of patients with T2D died within
5 years of a diagnosis of heart failure4§
In one study, the five-year Kaplan-Meier survival estimates were significantly lower in patients who developed HF compared with those without HF.4‡
For patients with T2D and HF, the 5-year survival rate is a mere 12.5%.4
For patients with T2D and no HF, the 5-year survival rate is greater than 80%.4
1. Cavender MA, Steg G, Smith SC, et al. Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) registry. Circulation. 2015;132(10):923-931. 2. Bertoni AG, Hundley WG, Massing MW, et al. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care. 2004;27(3):699-703. 3. Wang G, Zhang Z, Ayala C, et al. Costs of heart failure-related hospitalizations in patients aged 18-64 years. Am J Manag Care. 2010;16(10):769-776. 4. Bertoni AG, Hundley WG, Massing MW, et al. Heart failure prevalence, incidence, and mortality in the elderly with diabetes. Diabetes Care. 2004;27(3):699-703. 5. Gheorghiade M, De Luca L, Fonarow GC, et al. Pathophysiologic targets in the early phase of acute heart failure syndromes. Am J Cardiol. 2005;96(6A):11G-17G.
VIDEO: THE EPIDEMIOLOGY AND BURDEN OF HEART FAILURE IN TYPE 2 DIABETES (T2D)
For clinicians, the focus on A1C reduction and cardiovascular risk factors for our patients with T2D may make us less sensitive to the significant risk for heart failure that may develop in these patients.
This video, hosted by Dr. Sunder Mudaliar, a Clinical Professor of Medicine at the University of California San Diego School of Medicine, underscores the significance of heart failure as a potential complication of T2D.