During Saturday’s two-hour symposium Diabetes, Drugs and Heart Failure, which begins at 1:45 p.m. in Hall A, four experts will discuss several novel diabetes medications and their impact on heart failure.
Shannon M. Dunlay, MD, MS, will open the session with a review of the epidemiology of diabetes in heart failure. She will examine the structural and functional changes that occur in the heart in patients with diabetes and heart failure, as well as the mechanisms that cause the changes.
“As the first presenter in the session, I will set the stage to discuss the mechanisms and impact of novel diabetes medications on the development of heart failure and heart failure outcomes,” said Dr. Dunlay, Associate Professor of Health Services Research and Medicine at the Mayo Clinic in Rochester, Minnesota.
While researchers don’t fully understand the pathways by which diabetes leads to heart failure, Dr. Dunlay noted that they do know that the metabolic disturbances resulting from high blood glucose contribute to abnormalities in energy production and oxidative stress that contribute to heart dysfunction and, ultimately, heart failure.
“As diabetes and heart failure are so common in our population, it’s imperative that clinicians have a thorough understanding of the linkage between the two conditions,” she said. “Other talks in this session will focus on how to use existing therapies to optimize care for patients with diabetes at risk for heart failure, and those with established heart failure.”
Eldrin F. Lewis, MD, MPH, will discuss some of those therapies and the challenges of diabetes medication research. Managing diabetes and its complications while minimizing the risk of non-fatal cardiovascular events, including heart failure, is perhaps the most challenging aspect of diabetes drug research, he said.
“Diabetes has a very high prevalence in clinical heart failure trials,” said Dr. Lewis, Associate Professor of Medicine at Harvard Medical School and Director of the Cardiovascular Clerkship Program at Brigham and Women’s Hospital. “Development of heart failure among patients with diabetes carries a high risk for subsequent mortality and the strategies to prevent its development are important.”
Some drugs developed to lower glucose have been associated with varied risk for heart failure, noted Dr. Lewis, who will discuss the mechanisms and risks of these new drug classes.
“The SGLT-2 inhibitors show significant promise, with recent analysis suggesting a potential class effect,” said Dr. Lewis, who will review ongoing trials involving diabetes and non-diabetes patients.
“Future studies need to be developed to determine if glucose-lowering agents can be useful in people with existing heart failure,” he added.
E. Dale Abel MD, PhD, Director of the Fraternal Order of Eagles Diabetes Research Center and Professor of Internal Medicine, Endocrinology and Metabolism, at the Carver College of Medicine at the University of Iowa, will present a lecture titled “Mechanisms Linking Diabetes Therapies and Heart Failure.” Dr. Abel’s research focuses on elucidating the molecular mechanisms leading to cardiac dysfunction in diabetes, and the regulation of myocardial growth and metabolism by insulin signaling.
The symposium will conclude with a presentation by Jacob A. Udell MD, MPH, FRCPC, Assistant Professor in the Division of Cardiology, Faculty of Medicine, at the University of Toronto, who will discuss “Optimizing Care of the Patient with Diabetes and Heart Failure.” Using administrative healthcare databases, registries, and clinical trial populations, Dr. Udell studies the cardiovascular benefits and risks of new diabetes and antiplatelet therapies.