The latest emerging drugs for the treatment of diabetic cardiomyopathy

ABSTRACT

Introduction

Diabetic cardiomyopathy (DCM) is a serious complication of diabetes mellitus involving multiple pathophysiologic mechanisms. In addition to hypoglycemic agents commonly used in diabetes, metabolism-related drugs, natural plant extracts, melatonin, exosomes, and rennin-angiotensin-aldosterone system are cardioprotective in DCM. However, there is a lack of systematic summarization of drugs for DCM.

Areas Covered

In this review, the authors systematically summarize the most recent drugs used for the treatment of DCM and discusses them from the perspective of DCM pathophysiological mechanisms.

Expert opinion

We discuss DCM drugs from the perspective of the pathophysiological mechanisms of DCM, mainly including inflammation and metabolism. As a disease with multiple pathophysiological mechanisms, the combination of drugs may be more advantageous, and we have discussed some of the current studies on the combination of drugs

GRAPHICAL ABSTRACT

KEYWORDS:

• Diabetic cardiomyopathy
• drugs
• sodium-glucose cotransporter 2 inhibitor
• metformin
• PPARα-related drugs
• melatonin
• natural extracts of plants

Article highlights

• Some diabetes drugs exhibit cardioprotective mechanisms in diabetic cardiomyopathy independent of glycemic control.

• Sodium-glucose cotransporter 2 inhibitor exerts cardioprotective effects in diabetic cardiomyopathy through multiple pathophysiologic mechanisms.

• Metabolism-related drugs, Rennin-angiotensin-aldosterone system inhibitors, natural plant extracts, and melatonin are effective agents for the treatment of diabetic cardiomyopathy.

• Fatty acid oxidation appears to have a dual role in diabetic cardiomyopathy.

• Exosomes is a potential therapeutic target for diabetic cardiomyopathy.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was funded by [KeyME-KeyME-2020-004] of Key Laboratory of medical electrophysiology, and the fund [xtcx2019-13] of Collaborative Innovation Center for Prevention and Treatment of Cardiovascular Disease of Sichuan Province; Southwest Medical University. Sichuan Science and Technology Program [2022YFS0610, 2022YFS0614], Luzhou Municipal Peoples Government-Southwest Medical University Science and Technology Strategic Cooperation [2021LZXNYD-J33]. Gulin County People’s Hospital - Affiliated Hospital of Southwest Medical University Science and Technology strategic Cooperation [2022GLXNYDFY13]. Hejiang People’s Hospital - Southwest Medical University Science and Technology Strategic Cooperation Project [2021HJXNYD13, 2022HJXNYD05 and 2022-N-01-33] project of China International Medical Foundation.