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 Researchers studied nearly 49,000 patients with heart failure, one
of the most common reasons older adults go to the hospital. For half
of these patients, the research team had more than two and a half
years of data.
Over the course of the study, about 26,000 of these patients, or 53
percent, died.
Patients were 24 percent more likely to die during the study when
they also had type 2 diabetes, which is tied to aging and obesity
and happens when the body can’t properly use insulin to convert
sugar, or glucose, into energy.
With diabetes, heart failure patients were also 29 percent more
likely to have their first hospitalization during the study period,
researchers report in JACC: Heart Failure.
“What was surprising was that both low and high levels of blood
glucose were associated with high risk of hospital admission and
death, but well-controlled blood sugar levels were associated with a
much lower risk,” said lead study author Claire Lawson of the
University of Keele in the U.K.
“While diabetes and heart failure are a lethal combination, the
study showed that controlling blood sugar levels within a target
range and keeping them stable over time can virtually remove the
additional risk associated with the diabetes,” Lawson said by email.
Approximately one in five heart failure patients have diabetes,
Lawson said.
Heart failure happens when the heart muscle is too weak to
effectively pump enough blood through the body. Symptoms can include
fatigue, weight gain from fluid retention, shortness of breath and
coughing or wheezing. Medications can help strengthen the heart and
minimize fluid buildup in the body.
For the study, Lawson and colleagues examined records collected from
2002 to 2014 on people with heart failure in a national patient
registry the UK.
Patients with diabetes and dangerously high blood sugar were 75
percent more likely to be hospitalized and 30 percent more likely to
die during the study than heart failure patients without diabetes,
the study found.
At the same time, diabetics with dangerously low blood sugar were 42
percent more likely to be hospitalized and 29 percent more likely to
die.
People with diabetes who didn’t stay on medications to control this
condition were also more likely to die or be hospitalized than
patients without diabetes.
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The study wasn’t a controlled experiment designed to prove whether
or how diabetes might make hospitalization or an early death more
likely for people with heart failure.
Another limitation is that researchers lacked cardiac imaging data
that would help pinpoint the exact type and severity of heart
failure patients experienced, and this might have influenced the
odds of hospitalization or death during the study.
Newer diabetes medications might also change the relationship
between diabetes and the risk of hospitalization or death for people
with heart failure, said Dr. Paul Hauptman, director of heart
failure at Saint Louis University School of Medicine.
It’s possible that diabetes boosts risks for heart failure patients
because diabetes can accelerate the development of coronary artery
disease and sometimes contribute to what’s known as diabetic
cardiomyopathy, a heart muscle disorder, Hauptman, who wasn’t
involved in the study, said by email.
Even if the reasons for the relationships aren’t clear, it still
makes sense for patients with both diabetes and heart failure to
work closely with health care providers to monitor and control their
blood sugar, said Jennifer Bea, a researcher at the University of
Arizona in Tucson who wasn’t involved in the study.
“When heart failure patients also have diabetes, there isn’t one
single reason that they are more likely to be hospitalized or die
prematurely,” Bea said by email. “There are many and varied possible
explanations.”
SOURCE: http://bit.ly/2hvSXyq JACC: Heart Failure, online October
11, 2017.
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