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Patients with diabetes mellitus show an increased incidence of heart failure (HF) even after adjustment for well-established risk factors for HF such as hypertension and ischemic heart disease. The resulting specific form of cardiomyopathy is known as diabetes mellitus -related cardiomyopathy” (DMCM). Pathogenic mechanisms underlying DCM are likely to be multifactorial from altered myocardial metabolism (hyperglycemia, hyperinsulinemia, increased circulating fatty acids and triglycerides) to microvascular disease, and altered myocardial structure with fibrosis. Current guidelines recommendations for medical treatment on HF in patients with diabetes mellitus (DM) do not differ from those for patients without DM. Regarding the effect of different hypoglycemic drugs on HF in patients with DM, and considering the best available current evidence, the sodium-glucose-co-transporter 2 inhibitors and metformin seem to be especially effective in patients with T2D and HF.
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