Dr Aidin Rawshani

Blood sugar critical for the risk of heart failure


Heart failure is a diabetic complication – blood sugar is likely the answer

Heart failure is a very serious disease with a 5-year survival comparable to severe forms of cancer. It is only in the last 5 years that people with type 2 diabetes understand how common heart failure is and how high the risk is among those with type 1 diabetes.

Recommended: About heart failure

A scientific study from Shah and colleagues showed that heart failure and leg artery disease were actually the most common complications among 1.9 million people with type 2 diabetes in the UK. 5 Scientists from Gothenburg have shown that people with type 2 diabetes and type 1 diabetes have between 2 to 8 times increased risk of heart failure.6

The peculiarity of heart failure among people with diabetes is that the cause of heart failure differs from the “common causes”.

Among people who do not have diabetes, the most common causes (1) are high blood pressure and (2) coronary heart disease. But people with diabetes have additional (in addition to hypertension and coronary heart disease) one cause of heart failure, namely circulatory load.

What does that mean? Well, high blood sugar leads to a change in the dynamics of the cardiovascular system, and the load on the heart rises through an increased fluid load on the heart. This load is quite discreet, but since it is chronic, it becomes serious. Empagliflozin has been shown to protect against heart failure among people with type 2 diabetes.7

Now is another study showing how important it is with good blood sugar control and this time among people with type 2 diabetes. Poor blood sugar control (HbA1c 9.5%, ie 80 mmol/mol) almost doubled the risk of heart failure. 8

What about people without diabetes? If they have a high intake of sugar, do they have an increased risk of heart failure? Answer: It remains to be seen. There is still a lack of studies that can clearly answer the question.

Good blood sugar control is the result of good treatment, exercise and proper nutrition.

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