Journal Article

Exploring the Complex Relationship between Diabetes and Cardiovascular Complications: Understanding Diabetic Cardiomyopathy and Promising Therapies

Jayalakshmi Vallamkondu, Abhijit Dey, Ramesh Kandimalla, Leena Chacko, Tanushree Karmakar, P. Hemachandra Reddy, Saikat Dewanjee, Nilanjan Ghosh, Hiranmoy Bhattacharya, Sagnik Nag

2023

Overview

Diabetes mellitus (DM) and cardiovascular complications are two unmet medical emergencies that can occur together. The rising incidence of heart failure in diabetic populations, in addition to apparent coronary heart disease, ischemia, and hypertension-related complications, has created a more challenging situation. Diabetes, as a predominant cardio-renal metabolic syndrome, is related to severe vascular risk factors, and it underlies various complex pathophysiological pathways at the metabolic and molecular level that progress and converge toward the development of diabetic cardiomyopathy (DCM). DCM involves several downstream cascades that cause structural and functional alterations of the diabetic heart, such as diastolic dysfunction progressing into systolic dysfunction, cardiomyocyte hypertrophy, myocardial fibrosis, and subsequent heart failure over time. The effects of glucagon-like peptide-1 (GLP-1) analogues and sodium-glucose cotransporter-2 (SGLT-2) inhibitors on cardiovascular (CV) outcomes in diabetes have shown promising results, including improved contractile bioenergetics and significant cardiovascular benefits. The purpose of this article is to highlight the various pathophysiological, metabolic, and molecular pathways that contribute to the development of DCM and its significant effects on cardiac morphology and functioning. Additionally, this article will discuss the potential therapies that may be available in the future.

• Publisher: MDPI AG,MDPI
• Subject: Apoptosis / Bioenergetics / Biology (General) / Cardiomyocytes / Cardiomyopathy / Cardiovascular disease / Collagen / Complications and side effects / Congestive heart failure / Coronary artery disease / Coronary vessels / Dextrose / Diabetes / Diabetes mellitus / Diabetes therapy / diabetic cardiomyopathy / Ejection fraction / Epidemiology / Fatty acids / Fibrosis / Glucagon / Glucagon-like peptide 1 / Glucose / Growth factors / Heart diseases / Heart failure / Homeostasis / Hyperglycemia / Hypertension / Hypertrophy / Insulin resistance / Ischemia / lipotoxicity / Metabolic syndrome / Mortality / Muscle contraction / Oxidative stress / QH301-705.5 / Review / Risk factors / Structure-function relationships / Type 2 diabetes