Diabetic cardiomyopathy is a decline in heart function associated with diabetes, particularly when the diabetes is poorly controlled. Limited information on the exact mechanism of this disease is available, but studies in the early 2000s suggested that it was much more common than previously believed. Diabetic patients may need to attend regular screenings to check for this and other complications. Early diagnosis can provide more treatment and intervention options. There are also some measures that can be taken to prevent it.
In patients with diabetic cardiomyopathy, the left ventricle of the heart enlarges and does not work as efficiently. Over time, this can cause pulmonary edema, where fluid builds up around the lungs, along with peripheral edema, swelling in the legs. High blood pressure can occur, and eventually the patient experiences heart failure. The progression can be quite slow, and in the initial phases, patients may not have any noticeable symptoms, which means it may be diagnosed late.
Treatment for diabetic cardiomyopathy may become necessary when the combination of symptoms becomes significant enough to cause health problems, or when patients experience medical crises. A strained heart could experience ischemia, for example, where some of the blood supply is cut off and the muscle starts to die. This can lead to acute chest pain and distress, which may necessitate immediate care in a medical facility to identify and treat the problem. In other cases, a routine screening identifies the problem before the patient starts to experience symptoms.
Some cases of heart failure in diabetic patients are associated with coronary artery disease. In diabetic cardiomyopathy, however, the coronary arteries appear normal, and there is no other known cause for the heart failure. It is important to trace the condition back to its cause, because this can have an impact on treatment. Patients with diseased coronary arteries, for example, might benefit from stents or bypasses to support heart function, while diabetic cardiomyopathy can be harder to treat.
Managing this diabetes complication usually starts with controlling the diabetes more effectively. Keeping blood sugar within a safe range can help. Patients may need to make dietary adjustments and could need to consider more invasive medication management to control glucose levels. The same measures can also prevent diabetic cardiomyopathy by reducing the strain on the heart associated with hyperglycemia. Controlling the condition can help reduce the risk of other complications and extend the patient's lifespan as well.