Diabetic Cardiomyopathy: Distinct and Preventable Entity or Inevitable Consequence?

Diabetes represents one of the greatest public health threats of the twenty-first century. It is well recognized that diabetes is an important risk factor for the development of cardiovascular disease including heart failure. Although heart failure in diabetic patients is often multifactorial, there is evidence that diabetes can have direct affects on cardiac function, a condition referred to as diabetic cardiomyopathy. The relationship between metabolic disease and cardiac dysfunction has been an area of intense basic and clinical investigation for nearly 4 decades. Despite these efforts, specific therapies to prevent and/or reverse diabetic cardiomyopathy have been lacking. This review will discuss the current state of the field with a focus on strategies to minimize the impact of metabolic stress on cardiac dysfunction and heart failure.