[Interaction between congestive heart failure and diabetes mellitus: critical review of the literature].
It is known from the Framingham Heart Study that there is a relationship between congestive heart failure and diabetes mellitus. Diabetes can cause myocyte hypertrophy, interstitial fibrosis, impaired myocardial blood flow, increased turnover of free fatty acids, leading to the development of cardiomyopathy. On the other hand, heart failure increases catecholamine plasma levels and it may cause insulin resistance, leading to the development of diabetes. We report and discuss data from the literature: ACE-inhibitors do not alter glucose metabolism, non selective beta-blockers increase insulin resistance, while beta-blockers with vasodilating properties do not seem to alter insulin sensitivity, and high doses of diuretics seem to have a negative effect on glycemic parameters. Since diabetes has a high prevalence among patients with heart failure, it is clinically relevant to monitor glycemic parameters in such patients and also to evaluate changes in the therapy.
Ferrua
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S
Divisione Universitaria di Cardiologia Azienda Ospedaliera San Giovanni Battista Corso Dogliotti, 14 10126 Torino.
Bobbio
M
M
Grassi
G
G
Trevi
G
G
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D004232:Diuretics / Q000627:therapeutic use; D005544:Forecasting; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007333:Insulin Resistance
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001786:Blood Glucose; D004232:Diuretics
Interazioni tra scompenso cardiaco e diabete mellito: revisione critica della letteratura.