Abstract
Diabetes mellitus is a very important comorbidity in patients with heart failure,
as the common presence of both diseases significantly worsens the prognosis of patients.
In order to improve the outcome of these patients, it is essential to diagnose both
diseases at an early stage and to treat them in accordance with guidelines. In particular,
a differentiated medication plays a crucial role. The therapy of heart failure does
not differ in patients with diabetes and patients without diabetes. In the treatment
of diabetes mellitus, however, it is very important to choose substances that have
a positive effect on the cardiovascular outcome of patients. First-line treatment
of diabetes in patients with cardiovascular diseases should be metformin, followed
by a SGLT-2 inhibitor or GLP-1 receptor agonist with proven cardiac benefit. A rigorous
adjustment of risk factors according to current guidelines reduces cardiovascular
mortality and hospitalization rates. Glitazones and saxagliptin are associated with
increased hospitalization rates and should be avoided in heart failure.
Der Diabetes mellitus ist eine wichtige Komorbidität bei Patienten mit Herzinsuffizienz.
Liegen beide Erkrankungen gemeinsam vor, verschlechtert dies die Prognose der Patienten
nachhaltig. Um das Outcome zu verbessern, sind eine suffiziente Diagnostik und eine
differenzierte medikamentöse Therapie von entscheidender Bedeutung. Dieser Beitrag
gibt einen Überblick über Epidemiologie, Pathogenese, Diagnostik und therapeutische
Optionen.
