Diabetes is rapidly emerging as a major health crisis in India, with projections indicating a rise in the number of affected individuals from 77 million today to 124 million by 2045. At the same time, the country is also grappling with a surge in heart disease cases. The connection between diabetes and heart failure is well-documented, as both conditions share key risk factors such as obesity and hypertension.
According to Dr. Praveen Chandra, Chairman of Interventional Cardiology and Structural Heart at Medanta, The Medicity in Gurugram, “Diabetes greatly increases the risk of cardiovascular issues, including heart failure, because high blood sugar damages blood vessels.”
Beyond shared risk factors, the link between diabetes and heart failure runs deeper. Diabetic cardiomyopathy—where elevated blood sugar directly weakens heart muscle function—worsens the risk of heart failure. “Insulin resistance, which defines diabetes, leads to oxidative stress, microvascular dysfunction, and inflammation. These processes weaken the heart’s ability to pump blood efficiently,” explains Dr. Chandra. Compounding the issue, heart failure can also impair glucose metabolism, creating a dangerous cycle between the two conditions.
However, advancements in medical treatment are providing new hope for managing both diabetes and heart failure more effectively. For diabetes, continuous glucose monitors (CGMs) and insulin pumps offer more accurate blood sugar control.
Additionally, newer medications like SGLT-2 inhibitors and GLP-1 receptor agonists have shown promising outcomes. “We are also seeing the development of cutting-edge treatments like stem cell therapy and artificial pancreas devices, which could revolutionize diabetes management,” notes Dr. Chandra.
On the heart failure front, left ventricular assist devices (LVADs) have emerged as a crucial treatment for patients with severe heart failure. LVADs are mechanical pumps that assist the heart’s left ventricle in circulating blood to other organs, offering a lifeline to patients. “LVADs can serve as a bridge to heart transplantation or as long-term therapy, improving the quality of life for heart failure patients while stabilizing cardiac function,” explains Dr. Chandra.
By enhancing circulation, LVADs can also improve the management of diabetes by easing the metabolic strain on the heart.
Need for Integrated Management
Dr. Ashwin B. Mehta, Interventional Cardiologist and Director of Cardiology at Jaslok Hospital and Research Centre in Mumbai, underscores the need for an integrated approach to treat diabetes and heart failure. “Traditionally, these conditions have been managed separately, which overlooks the interconnected relationship between them. By addressing both simultaneously, patient outcomes can significantly improve,” says Dr. Mehta.
For many individuals with diabetes, heart disease is the leading cause of death and disability. Prolonged high blood sugar levels damage blood vessels, increasing the risk of heart-related complications.
Adding to the complexity, diabetic patients often struggle with other risk factors like high blood pressure, dyslipidemia, and elevated triglycerides—all of which contribute to heart disease. “One of the biggest challenges is that these conditions often don’t show obvious symptoms, making early detection difficult,” Dr. Mehta points out.
Given the high risk of heart failure in diabetic patients, Dr. Mehta stresses the importance of lifestyle changes and advanced heart failure therapies, such as LVAD treatment. “For diabetic patients with severe heart failure, LVAD therapy improves blood circulation and reduces symptoms like fatigue and shortness of breath. By enhancing heart function, LVADs can help stabilize blood sugar levels and reduce hospitalizations,” he explains. In some cases, LVAD therapy may even delay or eliminate the need for a heart transplant while improving survival rates.
The Path Forward
With the growing prevalence of both diabetes and heart failure in India, the need for an integrated care approach is clear. As emphasized by Dr. Chandra and Dr. Mehta, managing these interrelated conditions with advanced therapies and comprehensive strategies can dramatically improve patient outcomes. By closing the gap between diabetes management and heart failure treatment, healthcare professionals can offer patients a higher quality of life and better survival prospects.
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