Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 15, 2024; 15(8): 1677-1682
Published online Aug 15, 2024. doi: 10.4239/wjd.v15.i8.1677
Diabetic cardiomyopathy: Emerging therapeutic options
Cornelius James Fernandez, Sahana Shetty, Joseph M Pappachan
Cornelius James Fernandez, Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, United Kingdom
Sahana Shetty, Department of Endocrinology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
Joseph M Pappachan, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
Joseph M Pappachan, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
Author contributions: Fernandez CJ wrote the initial draft of the manuscript with some help from Shetty S and Pappachan JM by performing literature search, interpretation of relevant scientific data, and compiling the best evidence; Fernandez CJ and Shetty S also contributed to the critical revision, important intellectual content and figure preparation for the paper; Pappachan JM contributed to the conceptual design of the paper and provided additional input to the drafting, literature review, revision, and modifications of the paper; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sahana Shetty, MD, DM, Professor, Senior Researcher, Department of Endocrinology, Kasturba Medical College, Manipal Academy of Higher Education, Madhav Nagar, Manipal 576104, Karnataka, India. sahana.shetty@manipal.edu
Received: March 30, 2024
Revised: May 4, 2024
Accepted: May 20, 2024
Published online: August 15, 2024
Processing time: 117 Days and 11.1 Hours
Abstract

Diabetic cardiomyopathy (DbCM) is a common but underrecognized compli-cation of patients with diabetes mellitus (DM). Although the pathobiology of other cardiac complications of diabetes such as ischemic heart disease and cardiac autonomic neuropathy are mostly known with reasonable therapeutic options, the mechanisms and management options for DbCM are still not fully understood. In its early stages, DbCM presents with diastolic dysfunction followed by heart failure (HF) with preserved ejection fraction that can progress to systolic dysfunction and HF with reduced ejection fraction in its advanced stages unless appropriately managed. Apart from prompt control of DM with lifestyle changes and antidiabetic medications, disease-modifying therapy for DbCM includes prompt control of hypertension and dyslipidemia inherent to patients with DM as in other forms of heart diseases and the use of treatments with proven efficacy in HF. A basic study by Zhang et al, in a recent issue of the World Journal of Diabetes elaborates the potential pathophysiological alterations and the therapeutic role of teneligliptin in diabetic mouse models with DbCM. Although this preliminary basic study might help to improve our understanding of DbCM and offer a potential new management option for patients with the disease, the positive results from such animal models might not always translate to clinical practice as the pathobiology of DbCM in humans could be different. However, such experimental studies can encourage more scientific efforts to find a better solution to treat patients with this enigmatic disease.

Keywords: Diabetic cardiomyopathy; Diabetic cardiomyopathy; Heart failure; Pathobiology; Teneligliptin

Core Tip: Diabetic cardiomyopathy (DbCM) is a common and underrecognized complication of diabetes mellitus. The pathobiological mechanisms of DbCM are not fully elusive and the therapeutic options are not adequate. Stages of DbCM include diastolic dysfunction followed by heart failure (HF) with preserved ejection fraction, systolic dysfunction and HF with reduced ejection fraction in its order of progression. Zhang et al, in a recent issue of the World Journal of Diabetes, demonstrate the potential pathophysiological changes of DbcM and explore the therapeutic potential of teneligliptin in mouse models of DbCM. Such experimental models might harness better research efforts to find an appropriate therapeutic strategy for DbCM in the near future.