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Feb 07, 2019

Coordinating Care for Patients with Heart Failure and Diabetes

Diabetes worsens outcomes for people with diastolic heart failure, highlighting the need for coordinated care. 

Coordination of care is critical for those with both heart failure and diabetes, based on a recent summary of the complicated dynamic between diabetes and diastolic heart failure. The paper was recently published in the Journal of the American College of Cardiology and highlights the need for thoughtful treatment in patients with complex conditions.

Diastolic heart failure, also referred to as heart failure with preserved ejection fraction, is the most common form of heart failure, affecting more than 3 million U.S. adults. It occurs when the heart muscle contracts normally but doesn’t relax as it should, reducing blood flow to the rest of the body.

Unfortunately, patients with all forms of heart failure face increased risk for health complications. But those with diastolic heart failure and diabetes face notably worse outcomes than those without diabetes and require special care, as explained in the article.

Written by a team of experts on the issue, this paper summarized the latest data on heart failure.  It also offered recommendations to improve treatment and outcomes for patients.

The take-home message, according to authors, was that diastolic heart failure is a complex disease that can affect multiple organ systems in the body. For patients with diabetes and diastolic heart failure, those conditions together can make things even more complex.

Recent findings from the Get With the Guidelines–Heart Failure registry (a clinical database of information about the health care patients receive over a period of time) show that among patients with diastolic heart failure, those with diabetes face increased risk of hospitalization, longer length of stay, and are less likely to be discharged home after a hospital stay. Data also shows that patients with diastolic heart failure and diabetes are more likely to be readmitted to the hospital and face increased risk of death compared to those without diabetes.

The good news is that exercise, lifestyle changes and medication help with the management of diabetes and heart failure. However, it takes a coordinated effort among a team of providers to address these conditions and improve outcomes for the patient. With diabetes affecting an estimated 45% of people with diastolic heart failure, these efforts are critical to improving public health.

Authors hope that through advances in treatment and research, those with heart failure and diabetes will face improved outcomes and a better quality of life.

Read the full article in the Journal of the American College of Cardiology.

Questions for You to Consider

  • What is heart failure?

  • Heart failure occurs when the heart is unable to pump enough blood to the rest of the body. Although there is no cure for heart failure, treatments such as ACE inhibitors and ARBs can help improve outcomes as well as quality of life.
  • Why is shared decision making so important in heart failure care?

  • With a number of treatment options for heart failure patients, choosing which therapies are best for each patient has become increasingly confusing. And with many heart failure patients living longer lives than ever before, there are many treatment decisions to be made over the course of the disease. That's why it's important that heart failure patients work together with their doctors to choose the best treatment options in accordance with their preferences, goals and values.

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