Journal of Osh State University. Medicine
Journal of Osh State University. Medicine
e-ISSN 1694-8831
DOI: 10.52754/16948831
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Modern approaches to the diagnosis and treatment of heart failure in patients with type 2 diabetes mellitus

Ansar Bashirov

Received 20.02.2025, Revised 12.05.2025, Accepted 16.06.2025

Abstract

The aim of the study was to identify systemic limitations in the approaches to the diagnosis and treatment of chronic heart failure (CHF) in patients with type 2 diabetes mellitus (DM) based on the analysis of pathogenesis, verification methods, and treatment effectiveness. Within the framework of the theoretical approach, clinical-pathophysiological and organisational models of CHF in type 2 DM were reconstructed, followed by the comparison of diagnostic algorithms, therapeutic strategies, and statistical data from various national healthcare systems, along with an expert evaluation of the main pathogenetic mechanisms. During the theoretical analysis, it was established that the formation of CHF in type 2 DM was determined by the combined influence of diabetic cardiomyopathy, microvascular ischaemia, and chronic inflammation. Diagnostic algorithms based on ejection fraction (EF) assessment demonstrated limited sensitivity in patients with preserved systolic function, whose proportion reached 60-70%. The most informative early diagnostic methods were recognised as tissue Doppler echocardiography and the identification of fibrosis and overload biomarkers, including natriuretic peptides, soluble suppression of tumorigenicity-2 receptor, and galectin-3. The greatest evidence-based effectiveness in treating CHF in patients with type 2 DM was demonstrated by the combined use of four classes of drugs – angiotensin-converting enzyme inhibitors, β-adrenergic blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors). Significant differences in access to basic drug therapy were identified: up to 78% of patients in the USA received combined treatment, whereas in Kazakhstan – less than 45%. These discrepancies also appeared in mortality levels: 66.2 cases per 100,000 population in the USA, versus a marked increase in this indicator in certain regions of Kazakhstan. The obtained results substantiated the need to adapt clinical protocols considering phenotypic features of the combined pathology, which allowed for improved diagnostic accuracy, individualised therapy, and reduced cardiovascular mortality


Keywords:

myocardium; metabolic comorbidity; ischaemia; diastolic dysfunction; insulin; ejection fraction

https://doi.org/10.52754/16948645_2025_4(1)_8

Retrieved from Vol. 4, No. 1, 2025

Pages 8-20

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Suggested citation

APA
Bashirov, A. (2025). Modern approaches to the diagnosis and treatment of heart failure in patients with type 2 diabetes mellitus. Journal of Osh State University. Medicine, 4(1), 8-20. https://doi.org/10.52754/16948645_2025_4(1)_8
Vancouver
Bashirov A. Modern approaches to the diagnosis and treatment of heart failure in patients with type 2 diabetes mellitus. J Osh State Univ Med. 2025;4(1):8–20. doi:10.52754/16948645_2025_4(1)_8