Type 2 diabetes mellitus and heart failure are closely related, patients with type 2 diabetes mellitus have a higher risk of developing heart failure, and those with heart failure are at increased risk of developing type 2 diabetes. Although no specific randomized clinical trials have been conducted to test the effect of cardiovascular therapies (drugs and/or devices) in diabetic patients with heart failure, a lot of evidence shows that all interventions effective in improving prognosis in patients with heart failure reduced ejection fraction are equally beneficial in patients with and without diabetes. However, the use of disease-modifying drugs in patients with diabetes and heart failure reduced ejection fraction is a clinical challenge due to the increased risk of adverse effects. For example, β-blockers are underutilized in diabetic patients due to the theoretical unfavorable effects on glucose metabolism as well as the use of drugs that interact with the renin-angiotensin system can be challenged in patients with diabetic nephropathy because of the risk of hyperkalemia. This review outlines the current use of disease-modifying drugs in diabetic patients with heart failure reduced ejection fraction. In addition, the role of novel pharmacologic agents as type 2 sodium-glucose co-transporter inhibitors (SGLT2ii) is discussed.

2型糖尿病与心力衰竭密切相关，2型糖尿病患者发生心力衰竭的风险较高，患有心力衰竭的患者发生2型糖尿病的风险增加。尽管尚未进行特定的随机临床试验来测试心血管疗法（药物和/或装置）对合并心力衰竭的糖尿病患者的影响，但大量证据表明，所有有效改善心力衰竭患者预后的干预措施均降低了射血分数对糖尿病患者和非糖尿病患者同样有益。然而，由于不良反应的风险增加，在糖尿病和射血分数降低的心力衰竭患者中使用疾病缓解药物是一项临床挑战。例如，由于理论上对葡萄糖代谢的不利影响，β-受体阻滞剂在糖尿病患者中未得到充分利用，而且由于高钾血症的风险，在糖尿病肾病患者中使用与肾素-血管紧张素系统相互作用的药物可能受到挑战。本综述概述了目前在射血分数降低的心力衰竭糖尿病患者中使用疾病缓解药物的情况。此外，还讨论了新型药物作为 2 型钠-葡萄糖协同转运蛋白抑制剂 (SGLT2ii) 的作用。本综述概述了目前在射血分数降低的心力衰竭糖尿病患者中使用疾病缓解药物的情况。此外，还讨论了新型药物作为 2 型钠-葡萄糖协同转运蛋白抑制剂 (SGLT2ii) 的作用。本综述概述了目前在射血分数降低的心力衰竭糖尿病患者中使用疾病缓解药物的情况。此外，还讨论了新型药物作为 2 型钠-葡萄糖协同转运蛋白抑制剂 (SGLT2ii) 的作用。