Treatment of Type 2 Diabetes in Heart Failure (HFrEF or HFpEF)

Clinical Scenario

Adults with type 2 diabetes who have concurrent heart failure — whether with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF).

Treatment Approach

In this setting, the choice of glucose-lowering agent is driven by the cardiac comorbidity, not solely by A1C. The recommended approach centers on an SGLT2 inhibitor — selected specifically for its proven heart failure benefit — to address both glycemic management and prevention of heart failure hospitalizations.

Agent selection, sequencing, and full clinical guidance are available in the complete structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

In adults with type 2 diabetes who have heart failure (HF) (with either reduced or preserved ejection fraction), an SGLT2 inhibitor is recommended for both glycemic management and prevention of HF hospitalizations (irrespective of A1C) (Fig. 9.4).

DOI: 10.2337/dc26-S009

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