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Heart failure in diabetes is often overlooked
There are more and more diabetics in Germany. Numerous secondary diseases can occur in those affected. Diabetes often causes diseases of the cardiovascular system, such as chronic heart failure, over time. However, the reduced cardiac output is often not recognized. It can be dangerous.
Over three million Germans suffer from heart failure
According to health experts, more than three million people in Germany suffer from heart failure (heart failure). As a result of this disease, the heart is no longer able to provide the body with sufficient blood and oxygen. Among other things, this leads to shortness of breath, a decrease in performance, fatigue and water retention in the legs. Heart disease can also be fatal. Nevertheless, it is apparently often not recognized, as experts now report.
Early risk of death
Heart failure increases the risk of people with diabetes dying earlier than others and landing in the hospital more often.
But it seems that the decreased cardiac output is not always recognized.
This is indicated by at least current data that reflect everyday treatment in Germany and Austria, as reported by the DHD Foundation (The Heart Disease Diabetic) in the German Diabetes Foundation in a communication published by the Science Information Service (idw).
Increased risk of heart failure in diabetes
While international studies show that diabetes occurs in heart failure (HF) patients in 25 to 40 percent and the risk of HF in diabetes mellitus is increased twice, the prevalence lies in a recently published evaluation of the DPV (Diabetes Patient history documentation) at 5.1 percent.
The data pool of almost 290,000 patients with type 2 diabetes registered in DPV in the treatment period 2010 to 2015 was examined for the study published in the specialist journal "Diabetic Medicine".
The aim of the evaluation was to record the RF prevalence using ICD (International Classification of Diseases) coding and to analyze the treatment situation on the basis of standardized documentation with multicentre participation.
According to the information, over 400 treatment facilities, mainly from Germany and Austria, document diabetes-relevant patient data in the DPV register.
Undetected and untreated
"The fact that the frequency of heart failure in the DPV analysis was slightly lower than expected, at just over 5 percent, could be due to the fact that it was recorded solely using the ICD code," said study co-author Professor Diethelm Tschöpe, chairman of the DHD foundation.
According to the experts, it cannot be safely assumed that patients with type 2 diabetes were specifically examined for HF in the period from 2010 to 2015.
It is more likely that active diagnosis was missing in many cases, "especially since heart failure, as a prognostically important complication in diabetes, has only come to the fore in the past three years," said Tschöpe.
Clinical experience would currently show that heart failure and especially the early stages of HF in patients with diabetes often go undetected and untreated.
Longer duration of illness
According to the information in the DPV evaluation, the proportion of diabetes patients with HF increased with age as expected, with more women being affected than men.
In addition, heart-deficient diabetics had a longer period of illness with disturbed glucose metabolism.
They were treated with insulin more often than patients without HF, their HbA1c value was lower and their BMI (Body Mass Index) was higher.
Hypertension and lipid metabolism disorders were treated more intensively in heart failure patients with diabetes. (ad)