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This narrative review synthesizes evidence from multi-database searches and Australian sources, quantifying hospitalization and diabetes prevalence disparities and outlining prevention and management approaches. 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Ross 1,*, Utpal K. Mondal 2, Shakeel Mahmood 2, Feleke H. Astawesegn 2, Anayochukwu E. Anyasodor 2, M. Mamun Huda 3, Subash Thapa 2, Setognal B. Aychiluhm 2, Santosh Giri 2, Md. Ferdous Rahman 2, Muhammad J. A. Shiddiky 2, Mohammad Ali Moni 2 and Kedir Y. Ahmed 2  \nAcademic Editor: Daniele Masarone  \nReceived: 17 November 2025  \nRevised: 5 December 2025  \nAccepted: 8 December 2025  \nPublished: 31 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 College of Medicine, Ajman University, Ajman 346, United Arab Emirates  \n2 Rural Health Research Institute, Charles Sturt University, Orange, NSW 2800, Australia; [umondal@csu.edu.au](umondal@csu.edu.au) (U.K.M.); [shmahmood@csu.edu.au](shmahmood@csu.edu.au) (S.M.); [fastawesegn@csu.edu.au](fastawesegn@csu.edu.au) (F.H.A.);  \n[aanyasodor@csu.edu.au](aanyasodor@csu.edu.au) (A.E.A.); [suthapa@csu.edu.au](suthapa@csu.edu.au) (S.T.); [saychiluhm@csu.edu.au](saychiluhm@csu.edu.au) (S.B.A.);  \n[sgiri@csu.edu.au](sgiri@csu.edu.au) (S.G.); [mdfrahman@csu.edu.au](mdfrahman@csu.edu.au) (M.F.R.); [mshiddiky@csu.edu.au](mshiddiky@csu.edu.au) (M.J.A.S.);  \n[mmoni@csu.edu.au](mmoni@csu.edu.au) (M.A.M.); [kahmed@csu.edu.au](kahmed@csu.edu.au) (K.Y.A.)  \n3 School of Rural Medicine, Charles Sturt University, Orange, NSW 2800, Australia; [mhuda@csu.edu.au](mhuda@csu.edu.au)  \n* Correspondence: [a.ross@ajman.ac.ae](a.ross@ajman.ac.ae)  \nAbstract  \nBackground: Heart failure (HF) patients with a ‘reduced’ ejection fraction (HFrEF) have several proven treatment options, but for those with a ‘preserved’ ejection fraction (HFpEF) there are very few. However, recent trials such as the EMPEROR-Preserved and DELIVER have shown that sodium-glucose cotransporter 2 (SGLT2) inhibitors significantly reduce HF hospitalization in HFpEF patients, and these are now supported by both Australian and international guidelines. Methods: We undertook a narrative review using a structured multi-database search (MEDLINE, Embase, CINAHL, Scopus) and key Australian sources (AIHW, ABS, Department of Health and Aged Care) without geographic or publicationyear restrictions. Results: In Australia there were approximately 179,000 hospitalizations in 2020–2021 due to HF equating to a rate of 697 per 100,000 population. The age-standardized hospitalization rate for HF in remote and very remote areas was 1.8 times higher than in major cities. Likewise, since 2000 the prevalence of diabetes has nearly tripled, from 460,000 to 1.3 million. In remote areas, there were 47,600 diabetes hospitalizations in 2021–2022, with residents being 2.5 times more likely to be hospitalized for diabetes compared to those in major cities. Conclusions: In rural Australia, reducing preventable hospitalizationsand premature mortality from heart failure and type 2 diabetes requires a stronger rural generalist and general practitioner workforce, improved access to essential medicines and telehealth, and equity-focused evaluation.  \nKeywords: heart failure; type 2 diabetes; prevention; management; treatment; rural Australia  \n1. Introduction  \nHeart failure (HF) is a major public health challenge worldwide and a leading cause of hospitalization and mortality, with a substantial burden among people with type 2 diabetes mellitus (T2DM) [1–4] . In Australia, the burden of HF continues to increase, driven by an aging population, rising obesity and increase in the prevalence of T2DM, which has tripled since 2000 [5–7] . Rural and remote populations experience disproportionately higher rates of HF-related hospitalizations and mortality, exacerbated by limited access to  \nhealthcare services and the complexities associated with managing comorbid conditions such as T2DM [6,8] . These diff","cbCaigsPMj5qh782","https://ap.wps.com/l/cbCaigsPMj5qh782","pdf",684016,14,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# 1. Introduction\n# 2. Methods","[{\"question\":\"What gap in treatment options does the review highlight for HFpEF?\",\"answer\":\"The review notes that while HFrEF has several proven treatment options, HFpEF has very few supported options, though recent trials and guidelines support SGLT2 inhibitors for HFpEF-related hospitalization reduction.\"},{\"question\":\"How was the evidence gathered for the narrative review?\",\"answer\":\"The review used a structured multi-database search (MEDLINE, Embase, CINAHL, Scopus) and key Australian sources (AIHW, ABS, Department of Health and Aged Care) without geographic or publication year restrictions.\"},{\"question\":\"What does the review conclude is needed to reduce preventable hospitalizations in rural Australia?\",\"answer\":\"It concludes that reducing preventable HF- and type 2 diabetes-related hospitalizations and premature mortality requires a stronger rural generalist and general practitioner workforce, improved access to essential medicines and telehealth, and equity-focused evaluation.\"}]","Prevention and Management of Heart Failure Associated with Type 2 Diabetics in Rural Australia | PDF",1790761855,35]