Individualized Care Plans Advised for T2DM With Heart Failure
FRIDAY, June 7, 2019 -- Team-based care emphasizing development of individualized care plans is recommended for management of type 2 diabetes mellitus (T2DM) and heart failure, according to a scientific statement issued by the American Heart Association and Heart Failure Society of America and published online June 6 in Circulation.
Shannon M. Dunlay, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues summarized the epidemiology, pathophysiology, and impact of T2DM and its control on outcomes in heart failure and reviewed pharmacological and lifestyle management options.
The authors note that T2DM and heart failure often occur concomitantly, with each increasing the risk for the other. Patients with heart failure and T2DM have worse clinical outcomes than heart failure patients without T2DM. Optimal glycemic targets should be individualized for patients with T2DM and heart failure to reflect the burden of comorbidity, including heart failure severity. A glycated hemoglobin target range of 7 to 8 percent is recommended for most patients with heart failure. Potential considerations for use of glucose-lowering medications are presented, including harms and benefits, as well as the correlations of these medications with cardiovascular outcomes. Lifestyle management, including exercise and weight loss, should be integral to patient care. Approaches to chronic disease management require development of individualized plans of care that consider patient preferences and effective care coordination across health care team members.
"Because both DM and heart failure are chronic diseases, integrated care that actively engages patients, family, and providers is key to optimizing both quality and quantity of life," the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
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Posted: June 2019
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