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Access this article Similar content being viewed by others Data availability Not applicable Abbreviations ACC: Acetyl-CoA carboxylase ACE2: Angiotensin converting enzyme-2 ACS: Acute coronary syndrome ACEI: Angiotensin-converting enzyme inhibitors AKT: Protein kinase B AMP: 5-Adenosine monophosphate AMPK: 5-Adenosine monophosphate-activated protein kinase Ang II: Angiotensin II ANP: Atrial natriuretic peptide APN: Serum lipocalin ARB: Angiotensin II receptor blockers AS: Atherosclerosis ASCVD: Atherosclerotic cardiovascular disease AT: Angiotensin II type ATP: Adenosine triphosphate AT1R: Angiotensin II type I receptor BHB: -Hydroxybutyrate BMI: Body mass index BNP: Brain natriuretic peptide CaMKII: Calmodulin-dependent kinase II cAMP: Cyclic adenosine monophosphate CCR2: CC chemokine receptor 2 cGMP: Cyclic guanosine monophosphate CI: Chronotropic incompetence CI: Confidence interval CIMT: Carotid intima-media thickness CKD: Chronic kidney disease CPT-1: Carnitine palmitoyltransferase1 CRP: C-reactive protein cTGF: Connective tissue growth factor CV: Cardiovascular CVD: Cardiovascular disease CVOTs: Cardiovascular outcomes DGAT1: Diacylglycerol O-acyltransferase 1 EAT: Epicardial adipose tissue ECM: Extracellular matrix eNOS: Endothelial nitric oxide synthase Epac-1: CAMP-activated exchange protein-1 ERK: Extracellular signal-regulated kinase FFA: Free fatty acid GLP-1: Glucagon-like peptide-1 GLP-1 R: Glucagon-like peptide-1 receptors GLP-1 RAs: Glucagon-like peptide-1 receptor agonists GLS: Global longitudinal strain HF: Heart failure HFmrEF: Heart failure with mid-range ejection fraction HFpEF: Heart failure with preserved ejection fraction HFrEF: Heart failure with reduced ejection fraction HO-1: Heme oxygenase-1 HR: Hazard ratio hsCRP: Hypersensitive C-reactive protein ICAM-1: Intercellular adhesion molecule-1 IGT: Impaired glucose tolerance IL-1: Interleukin-1 KCCQ-CSS: Kansas City Cardiomyopathy Questionnaire Clinical Summary Score KBs: Ketone bodies LV: Left ventricle LVEF: Left ventricular ejection fraction LVH: Left ventricular hypertrophy MACE: Major adverse cardiovascular event MCP-1: Monocyte chemoattractant protein-1 MDA: Malondialdehyde MI: Myocardial infarction miR21: MicroRNA-21 MMPs: Matrix metalloproteinases mTOR: Rapamycin MRA: Mineralocorticoid receptor antagonists MRI: Magnetic resonance imaging 6MWD: 6-Minute walk distance NA: Not available NF-B: Nuclear factor-B NHE3: Sodium-hydrogen exchanger isoform 3 NLRP3: NOD-like receptor thermal protein domain associated protein 3 NOX: NADPH oxidase NO: Nitric oxide NPs: Natriuretic peptides Nrf-2: Nuclear factor erythroid 2-related factor 2 NT-proBNP: N-terminal pro-B-type natriuretic peptide NYHA: New York Heart Association ox-LDL: Oxidized low-density lipoprotein P: Probability PFK-1: Phosphofructokinase-1 PGC-1: PPAR- coactivator 1 PI3K: Phosphatidylinositol-3-kinase PKG: Protein kinase G PPAR: Peroxisome proliferator-activated receptor p70S6K: TRPV1-ribosomal protein 70 S6 kinase PTEN: Phosphatase and tensin homolog PVD: Polyvascular disease RAAS: Renin-angiotensin-aldosterone system RCTs: Randomized controlled trials ROS: Reactive oxygen species RyR2: Ryanodine receptor 2 Sc: Subcutaneous SERCA2a: Sarcoplasmic reticulum calcium ATPase 2a sGC: Soluble guanylate cyclase SGLT2i: Sodium-glucose cotransporter-2 inhibitors SH: Spontaneous hypertension SOD: Superoxide dismutase T2DM: Type 2 diabetes mellitus TNF-: Tumor necrosis factor- TXNIP: Thioredoxin interacting protein ULK1: UNC-51-like kinase 1 VAT: Visceral adipose tissue VCAM-1: Vascular cell adhesion molecule-1 Vs: Versus References McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bhm M, Burri H, Butler J, elutkien J, Chioncel O et al (2023) 2023 Focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure

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Risk Factors For Hypoglycemia The timing of hypoglycemia usually reflects the time-action profile of the administered insulin formulation

By the 1960s, researchers had demonstrated the incretin effect the phenomenon where glucose taken orally triggers much higher insulin release than glucose given intravenously

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