Association between Type 2 Diabetes Mellitus and Heart Failure in Bangladesh: Clinical and Epidemiologic Perspectives

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) and heart failure represent a growing public health burden in Bangladesh, with their co-existence leading to increased morbidity and mortality. This study was conducted to determine the prevalence of heart failure and its associated factors among T2DM patients in a tertiary care setting in Dhaka. Methods: This descriptive cross-sectional study was conducted from January to June 2024. A total of 220 adult patients with T2DM were enrolled using consecutive convenient sampling. Data on socio-demographic, clinical, and laboratory parameters were collected. All participants underwent echocardiographic evaluation to assess cardiac function. Statistical analysis, including t-tests and Chi-square tests, was performed to identify significant associations. Results: The mean age of participants was 58.5±9.2 years, with a male predominance (55.5%). The prevalence of heart failure was found to be 21.4% (n=47). Patients with heart failure were significantly older (p<0.01), had a longer duration of diabetes (p<0.05), and had higher mean HbA1c levels (p<0.01) compared to those without heart failure. Hypertension was highly prevalent in the heart failure group (91.5%). A notable finding was the high prevalence of diastolic dysfunction (DD), observed in 51.8% of the total cohort, highlighting a significant rate of subclinical cardiac impairment. Conclusion: The prevalence of heart failure among T2DM patients in Bangladesh is substantial and is significantly associated with advanced age, longer diabetes duration, poor glycemic control, and hypertension. The high rate of subclinical cardiac dysfunction underscores the need for proactive screening and early intervention strategies to mitigate this growing health burden.