Treatment of Type 2 Diabetes with Obesity and Symptomatic Heart Failure with Preserved Ejection Fraction

When type 2 diabetes occurs alongside obesity and symptomatic heart failure with preserved ejection fraction (HFpEF), the choice of glucose-lowering therapy extends beyond glycaemic targets — cardiovascular and heart-failure outcomes become a primary consideration.

Clinical Scenario

This protocol is intended for adults with type 2 diabetes who have concurrent obesity and symptomatic heart failure with preserved ejection fraction (HFpEF). The combination of these conditions requires careful agent selection to address both metabolic and cardiac disease burden.

Treatment Approach

The regimen prioritises glucose-lowering agents that have demonstrated specific benefits for heart failure-related symptoms and HF events — applied irrespective of the patient's current A1C level.

The complete agent selection, sequencing, and supporting evidence are detailed in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.2337/dc26-S009

In adults with type 2 diabetes, obesity, and symptomatic heart failure with preserved ejection fraction (HFpEF), the glucose-lowering treatment plan should include a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 RA with demonstrated benefits for HF-related symptoms and reduction in HF events (irrespective of A1C).

In adults with type 2 diabetes, obesity, and symptomatic HFpEF, the glucose-lowering treatment plan should include a GLP-1 RA with demonstrated benefits for HF-related symptoms and/or reduction in HF events (irrespective of A1C).

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