Metabolic, Structural And Biochemical Changes In Diabetes And The Development Of Heart Failure
Diabetes surges the potentiality of developing various complications leading to increased morbidity and mortality. Furthermore, it also escalates the risk of heart failure.The process follows a complex pathophysiology of mechanisms and the summary of the review put forth by Kim titled “Metabolic, structural and biochemical changes in diabetes and the development of heart failure” published in the Diabetologia Journal has been given below.
Objective:
This review highlights the mechanisms that promote cardiac dysfunction in diabetes.
Method:
The review was drafted using several research updates and medical knowledge.
Findings:
Energy metabolism is disturbed owing to the changes in lipid, insulin and glycemic levels. Hyperglycemia also elevates myocardial fatty acid oxidation, reduces myocardial uptake of glucose and thereby reduces cardiac efficiency. It brings about hypertrophy due to disturbances in miRNAs. Increase in oxidative stress due to this inflammatory process also results in the production of AGEs which promotes fibrosis.
Besides, the levels of calcium also decline due to reduced SERCA2 protein levels causing poor myocardial contraction. DNA methylation and poor regulation of non-coding RNAs result in dysregulation of genes associated with metabolic remodelling.
Glucotoxicity occurs as a result of increased enzyme activity. Overlooking these aspects, treatment efforts should be made to curb oxidation of myocardial fatty acid and increase myocardial glucose oxidation.
Apart from these pharmacological treatments, emphasis on lifestyle and dietary changes should be encouraged.
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