Diabetes Linked to Cardiovascular Diseases Beyond Atherosclerosis and Heart Failure

Atherosclerotic cardiovascular disease and heart failure have been major focuses of cardiovascular risk reduction in people with diabetes. This narrative review summarizes evidence on diabetes and other common cardiovascular diseases, drawing on conditions ranked in the 2023 Global Burden of Disease study. It also reviews available evidence on incretin hormone mimetics, including GLP-1 receptor agonists, and sodium/glucose cotransporter 2 (SGLT2) inhibitors in relation to these diseases.

The review identifies diabetes as a risk factor for atrial fibrillation, infective endocarditis, hypertensive heart disease, intracerebral haemorrhage and aortic stenosis. It reports lower risk of aortic aneurysm, subarachnoid haemorrhage and mitral regurgitation among people with diabetes than among those without diabetes. Evidence is lacking for possible associations with rheumatic heart disease, alcoholic cardiomyopathy and myocarditis.

The authors highlight a residual cardiovascular burden beyond atherosclerotic disease and heart failure, and suggest that incretin-based therapies and SGLT2 inhibitors might help prevent cardiovascular disease or improve outcomes across several conditions. The article is a narrative review, not a trial establishing treatment effects; the supplied text gives no quantitative estimates or specific clinical recommendations. Its discussion does not establish that these therapies should be used to prevent or treat the listed conditions.