Prevalence and predictors of type II diabetes mellitus in heart failure patients with reduced left ventricular ejection fraction, Madinah, Saudi Arabia

Background: Heart Failure (HF) occurs more commonly in patients with type II Diabetes Mellitus (DM). Conversely, recent publications suggesting that the reverse is also true. Many mechanisms have been suggested, including sympathetic nervous system overactivity. Also, neurohormonal activation leads to an increase in the levels of catecholamines and cortisol which inhibit pancreatic insulin secretion and stimulate hepatic gluconeogenesis and glycogenolysis. Methods: This is a cross-sectional study conducted at Madinah cardiac center involving HF patients with reduced left ventricular ejection fraction (HFrEF) during the period from 1-March-2011 to 20-June-2019. Patients were divided into two groups based on the presence or absence of type II DM. Results: Out of 1607 patients included in the analysis, 1078 (67.1%) were males, 127 (7.9%) had myocardial infarction (MI), 356 (22.2%) valvular heart disease, 597 (37.1%) Coronary Artery Diseases (CADs), 146 (9.1%) underwent percutaneous coronary interventions and 95 (5.9%) underwent coronary artery bypass grafting. 825 (51.3%) were hypertensive, 835 (52.0%) were anemic, 289 (18.0%) were smokers, and 629 (39.1%) had stage 3 chronic kidney diseases. About 56.1% of HF patients were diabetic. Multivariate analysis showed that older age [OR, 1.02; 95% CI, 1.01-1.03; p<0.001], presence of Hypertension (HTN) [OR, 4.06; 95% CI, 3.20-5.16; p<0.001], anemia [OR, 1.68; 95% CI, 1.33-2.13; p<0.001] or CADs [OR, 1.78-2.28; 95% CI, 1.01-1.03; p<0.001] were the independent predictors of type II DM. Conclusions: About 56.1% of HFrEF patients were diabetic. Older age, presence of HTN, anemia, or CADs were the independent predictors of type II DM.