Diabetes is a common modifiable risk factor and a significant contributor to mortality worldwide. Its etiology is complex and multifactorial, with an inherited component that involves the interactions between environmental factors and multiple genetic susceptibility alleles. Diabetes is the most common cause of cardiovascular disease and heart failure. Nearly 80% of diabetics die of cardiovascular disease or complications. Diabetic cardiomyopathy has been defined as ventricular dysfunction that occurs in diabetic patients independent of a recognized cause such as coronary artery disease (CAD) or hypertension. This review discusses the etiology of the condition, the mechanisms causing it, the factors affecting various aspects of the disease, and the treatment modalities that are available today and those currently under development. Diabetic cardiomyopathy, a complication of diabetes mellitus, is a condition characterized by left ventricular hypertrophy and diastolic dysfunction progressing to heart failure and systolic dysfunction, independent of hypertension or CAD. Hyperglycemia, insulin resistance, and hyperinsulinemia lead to an increase in serum fatty acids, oxidative stress, abnormal calcium handling, and hypertrophy. The changes in substrate oxidation profile and glucose availability, mitochondrial dysfunction, and microvascular dysfunction cause an energy shortage and further increase oxidative stress. The prognosis is worse than in other forms of heart disease and in comparison to patients with the same cardiac condition but without diabetes. Prevention of diabetes by lifestyle interventions and meticulous control of blood glucose and of aggravating conditions is the cornerstone of therapy. Insights from animal models and cell therapy provide a hope for a better future.
|Title of host publication||Cardiovascular Diseases|
|Subtitle of host publication||Nutritional and Therapeutic Interventions|
|Number of pages||22|
|State||Published - 1 Jan 2013|