Glycemic targets for patients with diabetes and heart failure should be individualized to reflect the comorbidity burden, including the severity of heart failure, ultimately balancing the benefits of lowering A1c with the potential risks. There is a paucity of heart failure–specific data to guide glycemic targets in patients with diabetes and heart failure. However, consistent with clinical practice guidelines for patients with diabetes and significant comorbidities, a target A1c range of 7%-8% for most patients with heart failure is appropriate.
Intensive glycemic control has not been shown to reduce the risk for all-cause mortality, cardiovascular mortality, or stroke. However, intensive treatment to achieve low A1c targets in type 2 diabetes lessens the long-term risk for microvascular events such as retinopathy, nephropathy, and peripheral neuropathy. Intensive glycemic control may also minimize the risk for nonfatal myocardial infarction.
Although diabetes and heart failure independently increase a patient's risk for developing the other condition, available data suggest that intensive glycemic control in patients with diabetes does not actually lessen the risk for heart failure.
Learn more about the management of glycemia.
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Cite this: Romesh Khardori, Yasmine S. Ali. Fast Five Quiz: Type 2 Diabetes and Heart Failure - Medscape - Feb 15, 2022.