A strong, bidirectional relationship exists between diabetes mellitus (DM) and heart failure (HF) and DM is responsible of the activation of several molecular and pathophysiological mechanisms that may, on the long term, damage the heart. However, the prognostic role of DM in the context of chronic and acute HF is still not yet defined and there are several gaps of evidence in the literature on this topic. These gaps are related to the wide phenotypic heterogeneity of patients with chronic and acute HF and to the concept that not all diabetic patients are the same, but there is the necessity to better characterize the disease and each single patient, also considering the role of other possible comorbidities. The aim of the present review is to summarize the pathophysiological mechanisms subtending the negative effect of DM in HF and analyze the available data exploring the prognostic impact of such comorbidity in both chronic and acute HF.

糖尿病 (DM) 和心力衰竭 (HF) 之间存在很强的双向关系，DM 负责激活多种分子和病理生理机制，从长远来看，这些机制可能会损害心脏。然而，DM 在慢性和急性 HF 背景下的预后作用仍未明确，关于该主题的文献中存在一些证据空白。这些差距与慢性和急性 HF 患者广泛的表型异质性以及并非所有糖尿病患者都相同的概念有关，但有必要更好地描述疾病和每个患者的特征，同时考虑其他因素的作用可能的合并症。