The Bi-directional Impact of Two Chronic Illnesses: Heart Failure and Diabetes - A review of the Epidemiology and Outcomes.

Heart failure and diabetes mellitus contribute significantly to the morbidity and mortality of the US population. The combined economic impact on the US health care system reaches nearly $300 billion. Much of this cost stems from the frequent hospital admissions and direct cost of managing the two diseases. The presence of diabetes significantly increases the risk of developing heart failure compared to the general population and diabetics with heart failure experience significantly higher mortality. Patients with heart failure have a high incidence of insulin resistance and are at increased risk of developing diabetes mellitus. Traditionally these two chronic illnesses have been managed in relative isolation. However the adverse effects of each disease has significant impact on the other. The combination of heart failure and diabetes mellitus significantly increases the morbidity and mortality compared to either in isolation. This paper reviews the epidemiology and impact of the bidirectional effects of these two chronic illnesses.