Diabetic cardiomyopathy (DbCM) is a sequela of diabetes. DbCM is characterized by abnormal cardiac structure and/or performance in the absence of coronary artery disease or hypertensive, valvular or congenital heart disease. We aimed to determine the prevalence of DbCM in the United States and EU5. PubMed was queried for epidemiological studies on DbCM from 2010 onwards using the terms (“diabetes” AND “cardiomyopathy”) OR (“diabetic cardiomyopathy”) AND (“incidence” OR “prevalence”). 563 articles were identified, 40 of which were screened for full text review based on the abstract indicating the reporting of original data captured in a general diabetic population. Ten of these were used either directly or to inform our analysis. Four of these studies reported data on DbCM having made appropriate exclusions for atherosclerosis mediated heart failure. However, only 2 of these were ultimately included based on the representativeness of the study population and thus generalisability of results. Many studies were excluded due to heterogeneity in definition of DbCM. Some studies clearly stated DbCM as the indication of interest, taking appropriate measures to exclude cases with a history of atherosclerosis mediated precursors such as coronary artery disease, hypertension, or valvular heart disease. Other studies were not clear in the exclusion criteria and for this reason were excluded. Based on our review, estimates in the literature for DbCM in type 2 diabetes without stringent clinical diagnostic criteria range from 12% to 48%. Of the two studies included in our analysis which clinically define DbCM according to diagnostic guidelines, estimates ranged from 17% to 24%. Our final estimate based on an average of these two was 21%, with some imputations for variation by age. There are ~30 million diabetics in the United States alone and we estimate 21% of diagnosed diabetics also have DbCM, which represents a huge burden of disease for which there is very limited robust epidemiological data.


R. Perfetti: Stock/Shareholder; Self; Applied Therapeutics. S. Shendelman: Stock/Shareholder; Self; Applied Therapeutics.

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