3 Feb 2023 • Published on the 3rd of February, 2023 UK Study Finds Heart Failure Rates Increase with Longer Duration of Diabetes in Nearly 24,000 Patients. The findings add to the growing body of evidence suggesting that duration of diabetes is an important and independent determinant of heart failure among patients with diabetes. The duration of diabetes may reflect cumulative effects of various adverse processes in the setting of diabetes. These adverse processes might include not only hyperglycemia, but also glucotoxicity, lipotoxicity, hyperinsulinemia, advanced glycosylation end products, oxidative stress, mitochondrial dysfunction, cardiac autonomic neuropathy, and coronary microvascular dysfunction. Long-duration diabetes may also contribute to declining kidney function, which can further worsen heart failure risk. Clinicians may need to consider more systematically the duration of diabetes when assessing people with diabetes for heart failure. The 2022 consensus report by the American Diabetes Association (ADA) recommends clinicians to measure natriuretic peptide or high-sensitivity cardiac troponin in all people with diabetes on at least a yearly basis to identify the earliest heart failure stages and implement strategies to prevent transition to symptomatic heart failure. These findings highlight the paramount role of the duration of diabetes and its interaction with glycemic control in the development of heart failure. Long duration of diabetes and poor glycemic control may result in structural and functional changes in the myocardium, which is likely to underlie the pathogenesis of heart failure among individuals with diabetes. Source- Medscape| Read full story