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In diabetes, HFpEF is predominantly driven by coronary microvascular disease/dysfunction, systemic inflammation, as well as cardiovascular autonomic dysfunction (which is very specific to diabetes) and a deficient heart oxidative metabolism, all leading to remodeling of the heart and increased stiffness, while HFrEF is predominantly driven by adverse remodeling secondary to accelerated atherosclerotic CVD (ASCVD)

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Patients who smoke should be offered smoking cessation support through NHS stop smoking services, which provides broader cardiovascular benefits beyond addressing cold extremities

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Applying glutathione directly to these trouble spots can help