Diabetes und Herzinsuffizienz

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.

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