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Diabetes and Heart Failure Is Double Trouble for Older Women

New research from the University of Alabama at Birmingham shows that the effect of diabetes on the severity of illness and risk of death for patients with heart failure is much worse in women than men. The effect is even more pronounced in older patients. The UAB research team, led by Ali Ahmed, M.D., MPH, associate professor in the division of gerontology, geriatrics and palliative care and director of UAB’s Geriatric Heart Failure Clinic and Geriatric Heart Failure Research, found that diabetes was associated with a significant increase in the risk of death and hospitalization in patients with heart failure. Women over age 65 had worse outcomes than men or younger women.

“Our results suggest that heart failure patients should be thoroughly evaluated for the presence of diabetes and if it is present, should be intensively managed based on published guidelines,” said Ahmed. “Further studies should test current interventions and develop new ones to reduce the adverse effects of diabetes in heart failure patients in general, and among older adults in particular.”

Ahmed and his colleagues examined 2,056 heart failure patients with diabetes compared to the same number of non-diabetic heart failure patients who had similar characteristics at baseline. They used a technique called propensity score matching to design their study while remaining blinded to study outcomes as in a randomized clinical trail. Patients were followed on average for 38 months and analysis performed in two stages; one to see if the effect of diabetes differed in male or female heart failure patients and a second to examine if the age of the patient contributed to the effect of diabetes.

Patients in this study were participants in the Digitalis Investigational Group (DIG) trial, a multi-center trial funded by the National Heart Lung and Blood Institute, one of the National Institutes of Health. The DIG trial examined 7788 patients at 302 sites in the U.S. and Canada.

Published online in Heart on May 8.