Clinical overview of diabetes mellitus as a risk factor for cardiovascular death

Rev Cardiovasc Med. 2021 Jun 30;22(2):301-314. doi: 10.31083/j.rcm2202038.

Abstract

Global diabetes mellitus prevalence is increasing. Metabolic disorders, such as type 2 diabetes, are associated with abnormal cardiac electrophysiology and increased risk of arrhythmias. Patients with both diabetes types (1 and 2) suffer from sudden cardac death (SCD) as a leading cause of mortality. Cardiovascular death is defined as death attributable to cardiovascular disease (CVD) occurring shortly within the symptom onset. This usually arises from life-threatening ventricular tachyarrhythmias that lead to hemodynamic instability, and subsequent shock and death. A variety of pathways have been suggested that link hypoglycaemia to the development of adverse cardiovascular outcomes, including blood coagulation abnormalities, inflammation, endothelial dysfunction and sympathoadrenal responses. We propose a four-step framework for the optimisation of SCD risk factors in diabetic patients, to include: raising awareness to influence health behaviour, provision of screening programs, use of technology within educational programs to improve patient engagement and effective provision of diabetic community teams.

Keywords: Cardiomyopathy; Cardiovascular disease; Diabetes mellitus; Hypoglycaemia; Sudden cardiac death.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac
  • Death, Sudden, Cardiac
  • Diabetes Mellitus, Type 2*
  • Humans
  • Risk Factors
  • Tachycardia, Ventricular*