Endocrine Abstracts

Introduction: Chronic heart failure (cHF) is an often and unrecognized cause of mortality among people with type 2 diabetes (T2D), more often in elderly. Assessment of cHF comprises of a combination of clinical symptoms, echocardiography and a biomarker N-terminal pro b-type natriuretic peptide. It is underestimated and not treated timely. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are treatment of choice for subjects with T2D and cHF, frequently not initiated in elderly. The AIM of our study was to assess presence of cHF, diabetes control, estimated glomerular filtration rate (eGFR) and SGLT2-inhibitor use in elderly with T2D hospitalized at the “Zvezdara” University Medical Center, during 2019.

Methods: This was a retrospective, observational study done with search of electronic data of hospitalised subjects 65 years of age, with the primary diagnosis of T2D, in whom echocardiography was performed. Duration of diabetes, presence of cHF, SGLT2-inhibitor use, HbA1c, eGFR and ejection fraction (EF) were assessed

Results: Search identified 123 hospitalized elderly subjects with T2D in whom echocardiography was performed. Of those, 70 were female, 53 male, on oral or insulin therapy, but only 3 subjects were on SGLT2-inhibitors. Chronic heart failure was identified in 72 subjects: 31 with preserved EF, while 41 had reduced EF. Subjects with cHF were significantly older (78.08±7.80 vs 74.82±6.78 years, P<0.02), with longer duration of diabetes (16.74±7.15 vs 12.45±7.51 years, P<0.001), higher HbA1c (8.73±2.66% vs 7.68±1.76%, P<0.01), lower EF (41.62±8.79% vs 55.41±6.40%, P<0.001) and a lower eGFR (46.20±23.51 vs 62.68±27.90 ml/min/1.73m2, P<0.001).

Conclusion: Chronic heart failure is a frequent cause of hospitalization of elderly subjects with T2D. It is associated with increasing age, longer duration of diabetes, poor diabetes control and lower eGFR. SGLT2-inhibitors were hardly present in therapy, even upon discharge from hospital, necessitating education of doctors.