Insulin implicated in higher death rate among diabetics with heart disease

• The question: Studies have shown that having diabetes makes a person more susceptible to heart failure, which occurs when the heart can't pump sufficient amounts of blood throughout the body.
• But does the combination of these disorders increase the risk of death?
• The latest: This study examined the medical records of 554 people with heart failure who were evaluated for a possible heart transplant.
• In the group of mostly men, 132 people were diabetic (most of them with type 2 diabetes), with 43 (about a third of the diabetics) treated with insulin.
• People with heart failure who used insulin were four times more likely to die within a year than the others.
• Those who treated diabetes with oral medications - such as a sulfonylurea, metformin or glitazone - had similar mortality rates as non-diabetics.
• One-year survival rates were 90 percent for non-diabetics, 86 percent for diabetics not treated with insulin and 62 percent for those who used insulin.
• Who may be affected by these findings?
• People with heart failure and diabetes, a dual condition that affects up to 2 million Americans.
• Caveats: The number of participants was small and included only people with more advanced heart failure.
• Their use of different heart failure medications may have affected the results.
• The study did not determine whether the oral diabetes drugs offered any cardiovascular benefits that altered the findings.
• Bottom line: People who have both heart failure and diabetes may want to talk with a doctor about ways to control the diabetes before insulin injections become necessary.