Diabetes mellitus type 2
ICD-10 E11 · ICD-11 5A11

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

Clinical Scenario

This protocol is for adults with type 2 diabetes who have obesity together with symptomatic heart failure with preserved ejection fraction (HFpEF). In this combination, the choice of glucose-lowering therapy is guided not by glycaemic targets alone — the cardiac and metabolic overlap defines which agents are appropriate.

Treatment Approach (Overview — Partial)

The glucose-lowering plan in this setting involves an SGLT2 inhibitor and/or an agent from the GLP-1 receptor agonist class, selected specifically for demonstrated benefit in symptomatic HFpEF and obesity.

The complete protocol — including agent selection, clinical criteria, and the full structured regimen — is available via the link below.

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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