Boris Krahulec
Diabetic cardiomyopathy is heart muscle disease in diabetics. Most frequent myocardial structural changes are myocardial interstitial fibrosis associated with increases in angiotensin II. The most important mechanisms of diabetic cardiomyopathy are metabolic disturbances directly caused by hyperglycemia. These are depletion of glucose transporter 4, increased free fatty acids, carnitine deficiency, changes in kalcium homeostasis together with small vesel disease, endothelial dysfunction, autonomic dysfunction, insulin resistance. Interaction with hypertension and ischemic heart disease is obvious. Clinical findings in diabetic cardiomyopathy are systolic and more often diastolic dysfunction and increased incidence of heart failure in diabetics. No specific therapy is recommended for diabetic cardiomyopathy, management of hyperglycemia, hypertension, hyperlipidemia, insulin resistence and endothelial dysfunction should be instituted and appropriate therapy of heart failure must be conducted.