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The increased frequency of HF is attributable to the cardiotoxic tetrad of ischaemic heart disease, left ventricular hypertrophy, diabetic cardiomyopathy and an extracellular volume expansion resistant to atrial natriuretic peptides. Activation of the renin\u2010angiotensin\u2010aldosterone system and sympathetic nervous systems results in cardiac remodelling, which worsens cardiac function. Reversal of remodelling can be achieved, and cardiac function improved in people with HF with reduced ejection fraction (HFrEF) by treatment with angiotensin\u2010converting enzyme inhibitors and \u03b2\u2010blockers. However, with HF with preserved ejection fraction (HFpEF), only therapy for the underlying risk factors helps. Blockers of mineralocorticoid receptors may be beneficial in both HFrEF and HFpEF. Glucose\u2010lowering drugs can have a negative effect (insulin, sulphonylureas, dipeptidyl peptidase\u20104 inhibitors and thiazolidinediones), a neutral effect (\u03b1\u2010glucosidase inhibitors and glucagon\u2010like peptide\u20101 receptor agonists) or a positive effect (sodium\u2010glucose co\u2010transporter\u20102 inhibitors and metformin).<\/jats:p>","DOI":"10.1111\/dom.13652","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T23:43:02Z","timestamp":1549410182000},"page":"1277-1290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Heart failure in the patient with diabetes: Epidemiology, aetiology, prognosis, therapy and the effect of glucose\u2010lowering medications"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-6126","authenticated-orcid":false,"given":"David S. 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