Hyperglycemia, insulin resistance, and hyperinsulinemia, the main physiologic
disturbances in diabetes, contribute to atherosclerotic cardiovascular disease
(ASCVD), hypertension, and multiple derangements of cellular metabolism,
function, and structure, as well as activation of the
renin-angiotensin-aldosterone system (RAAS). The different cardiomyopathies that
result from these processes clinically present as heart failure in diabetes.
AGE, advanced glycation end-product; FFA, free fatty acids.