Diabetes Mellitus and the Heart

Experimental and Clinical Endocrinology & Diabetes, vol. 130, pp. S123–S126

Abstract

Cardiovascular risk Patients with diabetes mellitus (DM) have a significantly increased risk of developing cardiovascular diseases with their sequelae of acute myocardial infarction, stroke and cardiovascular death. For example, even today a 60-year-old male patient with diabetes has 6 years less life expectancy compared to a metabolically healthy male of the same age, and a 60-year-old patient with diabetes and a previous history of a heart attack has 12 years less [ 1 ]. These data highlight the need for targeted risk stratification of patients with diabetes and the consistent treatment of diabetes, associated risk factors and cardiovascular disease. Patients with diabetes mellitus should be categorized according to their cardiovascular risk into those with very high cardiovascular risk, high cardiovascular risk and moderate cardiovascular risk [ 2 ]. Very high cardiovascular risk DM and existing cardiovascular disease, or end organ damage, or≥3 risk factors or diabetes duration>20 years. # High cardiovascular risk DM with a diabetes duration>10 years without end organ damage, but with an additional risk factor. # Moderate cardiovascular risk Young patients (type 1 diabetes<35 years; type 2 diabetes<50 years) with a diabetes duration<10 years without other risk factors. # Further risk stratification In addition to diagnostics for the above-mentioned risk stratification, patients with diabetes and hypertension or clinical suspicion of cardiovascular disease should receive a resting ECG. At present, no convincing data exist to use additional imaging techniques such as echocardiography, stress echocardiography, scintigraphy or MRI in asymptomatic patients with diabetes mellitus. As part of clinical routines, no determination of circulating biomarkers should be carried out as part of risk stratification. # Publication History Article published online: 31 March 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Authors 6

1. Katharina S. Schütt corresponding Aachen Department of Internal Medicine I-Cardiology

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Internal Medicine I – Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany

2. Thomas M. Forst

   Clinical Research Services

   Affiliation as printed

   CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany

   CRS Clinical Research Services Mannheim GmbH, Mannheim, Germany

3. Andreas L. Birkenfeld

   University of Tübingen · Helmholtz Munich · Universitätsklinikum Tübingen · German Center for Diabetes Research

   Affiliation as printed

   Department of Internal Medicine IV, University Hospital Tübingen, Germany

   Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, German Center for Diabetes Research (DZD e. V.), Germany

4. Andreas Zirlik

   Medical University of Graz · Graz University Hospital

   Affiliation as printed

   Department of Internal Medicine - Division of Cardiology, LKH University Hospital Graz, Medical University Graz, Austria

   Department of Internal Medicine - Division of Cardiology, LKH University Hospital Graz, Medical University Graz, Austria

5. Dirk Müller‐Wieland Aachen Department of Internal Medicine I-Cardiology

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Internal Medicine I – Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany

6. Nikolaus Marx Aachen Department of Internal Medicine I-Cardiology

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Internal Medicine I – Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany