Diabetic cardiomyopathy (DCM), as a cardiac complication caused by long-term diabetes, has a complex and cautious treatment process. However, in the actual treatment, there are some common misunderstandings, which may affect the treatment effect and prognosis of patients. The following is a detailed discussion of the misunderstandings in the treatment of diabetic cardiomyopathy:
Myth 1: Simply controlling blood sugar can cure many patients and doctors may think that as long as blood sugar is controlled within the normal range, diabetic cardiomyopathy can be effectively treated. However, this concept is one-sided. Although controlling blood sugar is the basis of treatment, controlling blood sugar alone is not enough to improve heart function comprehensively. Both the ACCORD study in the United States and the study at the University of Dundee in the United Kingdom found that lowering glycated hemoglobin (HbA1c) to too low a level (such as below 6%) may increase cardiovascular mortality in diabetic patients. Therefore, the Expert Consensus on Clinical Application of Hypoglycemic Drugs in Chinese Adults with Type 2 Diabetes Mellitus and Heart and Kidney Diseases recommends that the target range of HbA1c in patients with type 2 diabetes mellitus (T2DM) and heart failure should be controlled between 7.0% and 8.0%.
Myth 2: Neglecting Cardiovascular Risk Assessment Cardiovascular risk assessment is essential in the treatment of diabetic cardiomyopathy. However, some doctors may ignore this and do not conduct a comprehensive cardiovascular risk assessment of their patients. This may lead to inaccurate formulation of treatment plans, thus affecting the therapeutic effect. Since rosiglitazone was reported to increase the risk of cardiovascular death in patients with T2DM, the Food and Drug Administration (FDA) has required that all newly developed diabetes drugs be closely evaluated and monitored for the risk of cardiovascular disease. Therefore, in the course of treatment, we should pay close attention to the cardiovascular status of patients and adjust the treatment plan in time.
Misunderstanding 3: Over-reliance on drug therapy and neglect of lifestyle intervention Drug therapy plays an important role in the treatment of diabetic cardiomyopathy, but over-reliance on drug therapy and neglect of lifestyle intervention is also a misunderstanding. Moderate exercise can not only enhance blood circulation and improve microcirculation function, but also wash and massage the intima of blood vessels, which is conducive to maintaining the stability of blood sugar. At the same time, reasonable diet management is also the key to treatment. According to the doctor’s advice, patients should make a personalized diet plan, control the amount of food, and avoid excessive intake of sugar and fat. Through the organic combination of lifestyle intervention and drug treatment, the disease can be better controlled and the quality of life can be improved.
Myth 4: Neglecting the importance of cardiac rehabilitation Cardiac rehabilitation is an important part of the treatment of diabetic cardiomyopathy, including regular exercise, diet management and psychological support. However, some patients and doctors may overlook the importance of cardiac rehabilitation and do not include it in their treatment plans. Cardiac rehabilitation can help improve the prognosis of patients by reducing the pressure on the heart, improving cardiopulmonary function and enhancing the ability of the heart to resist disease. Therefore, in the course of treatment, patients should be encouraged to actively participate in cardiac rehabilitation programs and develop appropriate rehabilitation programs according to their individual conditions.
With the continuous progress of medical technology, new hypoglycemic drugs are constantly emerging, which provides a new choice for the treatment of diabetic cardiomyopathy. However, some patients may blindly pursue new hypoglycemic drugs, ignoring the indications and contraindications of drugs. When choosing hypoglycemic drugs, the specific conditions of patients (such as age, gender, liver and kidney function, etc.) And the characteristics of drugs should be considered comprehensively. At the same time, we should also pay attention to the side effects and interactions of drugs to avoid unnecessary risks.
To sum up, the treatment of diabetic cardiomyopathy needs to consider many aspects comprehensively to avoid falling into the above misunderstanding. Through scientific and reasonable treatment plan and comprehensive lifestyle intervention, the disease can be effectively controlled and the quality of life of patients can be improved.
Cardiomyopathy
