Supportive care in the management of patients with heart failure and diabetes mellitus

Abstract

Heart failure (HF) and diabetes mellitus (DM) has become a major and increasing health problem worldwide. HF and DM most of the times occur together, aggravating patients’ outcomes and each disease of HF and DM independently increases the risk for the other. The growing widespread presence of patients with the comorbidity of HF and DM and the interaction of the two conditions, which is complex, the application of effective management programs is necessary, in order to improve patients’ outcomes. Despite the progress in the treatment of HF and DM, the already existing management programs applied for HF population, most of them are encouraging but still, the main reason of decompensation is no adherence to the therapy and many patients feel are not supported enough. HF deteriorations lead to readmissions and the morbidity and mortality of HF patients are increased and the hazard of deterioration was found to be higher in patients with DM. New effective approaches are necessary for improving the care, in order to minimize the burden of exacerbations and complications in HF and DM patients who have to deal everyday with various difficult and complex factors; follow a specific type of lifestyle and optimize specific health behaviors. Patients’ education only, is not effective for the development of self-care skills in the specific group of patients and this finding makes HF-DM management and supportive care that is patient-centred, based on patients’ needs, complementary to ensure the best possible health related quality of life (HR-QoL). Supportive care in HF consists of four components: communication, education, psychological and spiritual issues and symptom management.