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Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

• With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
• With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
  • Too weak to pump enough blood.
  • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

• Arrhythmia (a problem with the rate or rhythm of your heartbeat)
• Cardiomyopathy
• Congenital heart defects or other types of heart diseases that you are born with
• Coronary artery disease
• Endocarditis
• Heart attack
• Heart valve diseases
• High blood pressure
• A blood clot in your lung
• Diabetes
• Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
• Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

• You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
• Your family health history includes relatives who have or have had heart failure.
• You have changes in your genes that affect your heart tissue.
• You have habits that can harm your heart, including:
  • Smoking
  • Eating foods high in fat, cholesterol, and sodium (salt)
  • Having an inactive lifestyle
  • Alcohol use disorder (AUD)
  • Illegal drug use
• You have other medical conditions that can affect your heart, including:
  • Any heart or blood vessel conditions, including high blood pressure
  • Serious lung diseases
  • Infection, such as HIV or COVID-19
  • Obesity
  • Diabetes
  • Sleep apnea
  • Chronic kidney disease
  • Anemia
  • Iron overload disease
  • Cancer treatments that can harm your heart, such as radiation and chemotherapy
• You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

• Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
• Fatigue or weakness even after rest.
• Coughing.
• Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
• Difficulty sleeping when lying flat.
• Nausea and loss of appetite.
• Swelling in the veins of your neck.
• Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

• Breathing problems from fluid in and around your lungs (also called congestive heart failure)
• Kidney or liver damage including cirrhosis
• Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
• Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
• Pulmonary hypertension

To find out if you have heart failure, your doctor will:

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart failure
• Do a physical exam
• Will likely order heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your doctor may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

• Taking medicine
• Eating less sodium and drinking less liquid to control fluid buildup
• Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your health care provider recommends
• Treating any conditions that may make heart failure worse

You may need heart surgery if:

• You have a congenital heart defect or damage to your heart that can be fixed.
• The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
  • An implantable cardioverter defibrillator.
  • A biventricular pacemaker (cardiac resynchronization therapy).
  • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
• Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

You may be able to prevent or delay heart failure if you:

• Work with your provider to manage any health conditions that increase your risk of developing heart failure
• Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Blood glucose, or blood sugar, is the main sugar found in your blood. It is your body's primary source of energy. It comes from the food you eat. Your body breaks down most of that food into glucose and releases it into your bloodstream. When your blood glucose goes up, it signals your pancreas to release insulin. Insulin is a hormone that helps the glucose get into your cells to be used for energy.

For people with diabetes, your body doesn't make enough insulin, can't use it as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells.

Hypoglycemia means low glucose. It happens when the level of glucose in your blood drops below what is healthy for you:

• For many people with diabetes, this means a blood glucose level lower than 70 mg/dL. Your number might be different, so check with your health care team to find out what blood glucose level is too low for you.
• For people who don't have diabetes, hypoglycemia is typically a blood glucose level lower than 55 mg/dL.

Hypoglycemia is common in people who have diabetes type 1 or who have diabetes type 2 and take insulin or other diabetes medicines. It can happen:

• As a side effect of insulin or some other medicines that help your pancreas release insulin into your blood. These medicines can lower your blood glucose level.
• If you don't eat or drink enough carbohydrates (carbs). Carbs are the main source of glucose for your body.
• If you get a lot more physical activity than usual.
• If you drink too much alcohol without enough food.
• When you are sick and can't eat enough food or keep food down.

Although it's rare, you can still get low blood glucose without having diabetes. The causes can include conditions such as liver disease, kidney disease, and hormone deficiencies (lack of certain hormones). It can also happen in people who have had certain types of weight loss surgery. Some medicines, such as certain heart medicines and antibiotics, can also cause it. See your health care provider to find out the cause of your low blood glucose and how to treat it.

The symptoms of low blood glucose tend to come on quickly. The symptoms can be different for everyone, but they may include:

• Shaking
• Sweating
• Nervousness or anxiety
• Irritability or confusion
• Dizziness
• Hunger

If you have diabetes, you'll most likely need to check your blood glucose every day and make sure that it's not too low. You can do this with a blood glucose meter or continuous glucose monitoring (CGM) system.

There are also blood tests that providers can use to check if your blood glucose is too low.

If you don't have diabetes and you have hypoglycemia, your provider will likely order other tests to try to figure out the cause.

If you have mild or moderate hypoglycemia, eating or drinking something with carbohydrates can help. But severe hypoglycemia can cause serious complications, including passing out, coma, or even death. Severe hypoglycemia can be treated with glucagon, a hormone that raises blood glucose levels. It can be given as nasal spray or injection. If you have diabetes, your provider can prescribe you a glucagon kit for use in case of an emergency.

If you have diabetes and you often have mild or moderate low blood glucose, your health care team may make changes to your diabetes meal plan, physical activity plan, and/or diabetes medicines.

If you don't have diabetes and you keep having low blood glucose, the treatment will depend on what is causing it to happen.

If you have diabetes and you take insulin or other medicines that lower blood glucose, you can help prevent hypoglycemia if you:

• Follow your diabetes meal plan. Eat and drink enough carbs to keep your blood glucose in your target range. Also carry a source of fast-acting carbohydrate, such as glucose tablets or a juice box, with you in case your blood glucose gets too low.
• Be safe during physical activity. Check your blood glucose before and afterwards. You may need to eat a snack before your physical activity.
• If you take diabetes medicines, make sure to take them correctly.

Diabetes, also known as diabetes mellitus, is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose is your body's main source of energy. Your body can make glucose, but it also comes from the food you eat. Insulin is a hormone made by your pancreas. Insulin helps move glucose from your bloodstream into your cells, where it can be used for energy.

If you have diabetes, your body can't make insulin, can't use insulin as well as it should, or both. Too much glucose stays in your blood and doesn't reach your cells. This can cause glucose levels to get too high. Over time, high blood glucose levels can lead to serious health conditions. But you can take steps to manage your diabetes and try to prevent these health problems.

There are different types of diabetes:

• Type 1 diabetes. If you have type 1 diabetes, your body makes little or no insulin. It happens when your immune system attacks and destroys the cells that produce insulin.
• Type 2 diabetes. This is the most common form of diabetes. If you have type 2 diabetes, your body may still be able to make insulin, but your cells don't respond well to insulin. They can't easily take up enough glucose from your blood.
• Gestational diabetes. This is a form of diabetes that develops during pregnancy. It happens when your body can't make the extra insulin it needs during pregnancy.

The different types of diabetes have different causes:

• Researchers think type 1 diabetes is caused by genes and factors in the environment that might trigger the disease.
• Type 2 diabetes is caused by several factors, including lifestyle factors and genes. The lifestyle factors include not being physically active and being overweight or having obesity.
• Researchers think gestational diabetes is caused by the hormonal changes of pregnancy along with genetic and lifestyle factors.

The different types of diabetes have different risk factors:

• You can develop type 1 diabetes at any age, but it most often starts in childhood. Having a parent or sibling with type 1 diabetes may increase your chance of developing it.
• You are at higher risk of developing type 2 diabetes if you:
• Are overweight or have obesity.
• Are over age 35. Children, teenagers, and younger adults can get diabetes, but it is more common in middle-aged and older adults.
• Have a family history of diabetes.
• Have prediabetes. This means that your blood glucose is higher than normal, but it's not high enough to be called diabetes.
• Had gestational diabetes.
• Have given birth to a baby weighing 9 pounds or more.
• Are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
• Are not physically active.
• Have certain other health conditions, such as high blood pressure or polycystic ovary syndrome (PCOS).
• You are at higher risk of developing gestational diabetes if you:
• Are overweight or have obesity.
• Have a family history of diabetes.
• Had gestational diabetes in a previous pregnancy.
• Have given birth to a baby weighing 9 pounds or more.
• Have polycystic ovary syndrome (PCOS).
• Are African American, Hispanic/Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.

The symptoms of diabetes may include:

• Feeling very thirsty
• Feeling very hungry
• Urinating (peeing) more often, including at night
• Fatigue
• Blurry vision
• Numbness or tingling in the feet or hands
• Sores that do not heal
• Losing weight without trying

But it's important to know that your symptoms may vary, depending on which type you have:

• The symptoms of type 1 diabetes usually come on quickly and can be severe.
• With type 2 diabetes, the symptoms often develop slowly, over several years. The symptoms can be so mild that you might not even notice them.
• Gestational diabetes often has no symptoms. If you do have symptoms, they may be mild. People who are pregnant are usually screened for this condition between 24 and 28 weeks of pregnancy.

To find out if you have diabetes, your health care provider will use one or more glucose blood tests. There are several types, including the A1C test.

Treatment for diabetes involves managing your blood glucose levels:

• If you have type 1 diabetes, you will need to take daily doses of insulin, either by injection or through a special pump. Some people also need to take another type of diabetes medicine that works with insulin.
• If you have type 2 diabetes, you may be able to manage or even reverse it by making lifestyle changes. These include eating a healthy diet, staying at healthy weight, and getting regular physical activity. Some people also need to take diabetes medicines to manage their diabetes.
• If you have gestational diabetes, you may be able to lower your glucose levels by eating a healthy diet and getting regular exercise. But be sure to talk to your provider about your treatment options. Gestational diabetes usually goes away after you give birth. But you will have a higher risk of developing type 2 diabetes later.

Checking your blood glucose levels is also an important part of managing your diabetes. Ask your provider about the best way to check your blood glucose level and how often you should check it.

Type 1 diabetes can't be prevented.

You may be able to delay or prevent type 2 diabetes through the same lifestyle changes that are used to manage diabetes (eating a healthy diet, staying at a healthy weight, and getting regular physical activity). These lifestyle changes may also help prevent gestational diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose,or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood.

Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well.

Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children:

• Have them maintain a healthy weight
• Be sure they are physically active
• Have them eat smaller portions of healthy foods
• Limit time with the TV, computer, and video

Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check on how you are managing your diabetes.

Hormones are your body's chemical messengers. They travel in your bloodstream to tissues or organs. They work slowly, over time, and affect many different processes, including:

• Growth and development
• Metabolism - how your body gets energy from the foods you eat
• Sexual function
• Reproduction
• Mood

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands, and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be serious. Laboratory tests can measure the hormone levels in your blood, urine, or saliva. Your health care provider may perform these tests if you have symptoms of a hormone disorder. Home pregnancy tests are similar - they test for pregnancy hormones in your urine.

The pancreas is a gland behind your stomach and in front of your spine. It produces the juices that help break down food and the hormones that help control blood sugar levels. Pancreatic cancer usually begins in the cells that produce the juices. Some risk factors for developing pancreatic cancer include:

• Smoking
• Long-term diabetes
• Chronic pancreatitis
• Certain hereditary disorders

Pancreatic cancer is hard to catch early. It doesn't cause symptoms right away. When you do get symptoms, they are often vague or you may not notice them. They include yellowing of the skin and eyes, pain in the abdomen and back, weight loss and fatigue. Also, because the pancreas is hidden behind other organs, health care providers cannot see or feel the tumors during routine exams. Doctors use a physical exam, blood tests, imaging tests, and a biopsy to diagnose it.

Because it is often found late and it spreads quickly, pancreatic cancer can be hard to treat. Possible treatments include surgery, radiation, chemotherapy, and targeted therapy. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells.

NIH: National Cancer Institute