The national diabetes epidemic is particularly concerning for people aged 65 and older, since this demographic group is disproportionately affected by the disease. Although Americans 65 and older represent 16.8 percent of the U.S. population, data suggests that these individuals account for 29% percent of the Americans with diabetes, estimated at 15.9 million individuals according to the American Diabetes Association.
Managing diabetes on its own can be challenging, but what is even more concerning is that people with diabetes are at higher risk for heart failure. Studies have found that individuals with Type 2 diabetes are two to four times more likely to develop heart failure than those without diabetes.
The health impact of both conditions is considerable. The American Heart Association (AHA) reports that people with both diabetes and heart failure are hospitalized more often, visit the emergency room more frequently, and have shorter lifespans than individuals with just one of these conditions.
Earlier identification of heart failure: The impact on quality of life can be immense
Given the linkage between heart failure and diabetes, the American Diabetes Association (ADA) recommends annual screening for early-stage heart failure among older individuals with diabetes.
Earlier identification of heart failure supports life-changing, patient-centric care that may include:
- Earlier intervention. For people with a dual diagnosis of heart failure and diabetes, value-based care organizations can proactively work with patients to implement care management strategies earlier in the disease progression. Some individuals may be good candidates, for example, for pharmacologic treatments like SGLT-2 inhibitors.
- Patient education designed to manage the advancement of disease. Healthcare providers should emphasize the importance of AHA and ADA lifestyle recommendations, such as decreasing alcohol consumption, reducing smoking, following a healthy diet, and managing weight.
- Opportunities for advanced care planning. Early identification of heart failure enables healthcare providers to design care plans that are more effective than treatments for late-stage diagnoses and in alignment with patient wishes.
All of these actions can result in improved health outcomes, as well as healthier days at home. In addition, earlier diagnosis of heart failure among individuals with diabetes typically results in care that is less costly than treatment and management of late-stage diagnosis. Direct medical costs associated with heart disease (not including stroke) totaled $281 billion in 2015 in the United States – a figure that could more than double by 2035, due to the expanding population of older Americans.
Non-invasive diagnostic testing: A new way to identify heart failure in older populations with diabetes
Until now, identifying heart failure earlier in high-risk populations, like those with diabetes over 65 years old, has been challenging. Existing diagnostic tools, such as cardiac catheterization, often aren’t well-suited for use as a frontline screening tool because they are invasive and must be performed at specialist care centers.
Clinicians may also order an echocardiogram before ordering cardiac catheterization – another test potentially delaying an early diagnosis as echocardiograms often face their own set of challenges in aiding in the diagnosis of heart failure. They can be time consuming for clinicians to complete, require trained technicians to perform and do not reliably detect the gold standard measurement to diagnosis heart failure – elevated left ventricular end diastolic pressure (LVEDP).1-4
In addition, various social determinants of health (SDOH) can make it difficult for older patients to pursue testing that is considered the gold standard for diagnosing heart failure – examples include limited access to transportation, disabilities, or language-related barriers. Scheduling day procedures in a hospital environment is another hurdle, since multiple appointments may be needed – one for the test and another to discuss the results.
To close care gaps and provide accessible care, value-based care organizations need a better solution that pushes past traditional diagnostic pathways. Ventric Health’s Vivio System™ represents the future of health. It is the first and only device to non-invasively aid in the diagnosis of heart failure in clinical or home healthcare settings. Vivio is validated against the gold standard hemodynamic definition of heart failure – elevated LVEDP.3-4
Using Vivio takes less than five minutes to administer and, since the technology is portable, it bridges health equity gaps by lowering barriers to care for individuals affected by SDOH. By equipping clinicians with the Vivio System, it’s possible to shift the timeline of heart failure diagnosis for those with diabetes and begin proactive, patient-centric care sooner which can improve health outcomes and reduce costs.
Innovation that elevates access and improves lives
When it comes to older patients with diabetes, value-based care organizations are no longer limited by the status quo for diagnosing heart failure. Vivio has created an approach to testing that is more accessible, less time-consuming and less costly. The result is earlier identification, earlier interventions, and a higher quality of life for patients.
Together, we can be the change that changes heart health.
- Kimura, Bruce J, and Anthony N DeMaria. “Time Requirements of the Standard Echocardiogram: Implications Regarding Limited Studies.” Journal of the American Society of Echocardiography, vol. 16, no. 10, Oct. 2003, pp. 1015–1018, https://doi.org/10.1016/s0894-7317(03)00590-x. Accessed 18 Apr. 2022.
- Lancellotti P, Galderisi M, Edvardsen T, et al. Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. European Heart Journal - Cardiovascular Imaging. 2017;18(9):961-968. doi:https://doi.org/10.1093/ehjci/jex067
- Borlaug BA. Evaluation and management of heart failure with preserved ejection fraction. Nature Reviews Cardiology. 2020;17:559573.
- McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J and Chioncel O. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal. 2021;42:3599-3726.