Echocardiographic feature of diabetic cardiomyopathy: where are we now?

We are now entering the very exciting era of treatment and management of diabetes mellitus (DM) with the emergence of new therapeutic agents, including sodium-glucose cotransporter 2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitor (DPP-4i). From a cardiology and echocardiography perspective, the existence of diabetic cardiomyopathy has been proven through over four decades of discussion. DM is highly prevalent in patients with heart failure (HF). Independent associations are found after adjusting for hypertension (HTN) and coronary artery disease (CAD). In patients with both DM and HF, the prognosis is extremely dismal. In this review, the main focus is on both diabetic cardiomyopathy per se and its typical features (including myocardial additive insult related to DM), diagnosis, and management.