Clinical Research Directory

Inclusion Criteria: * Male or female ≥40 years of age * Informed consent * An established diagnosis of diabetes (type 1 or type 2) * At least one additional risk factor for heart failure: 1. Coronary artery disease (either a previous documented type 1 myocardial infarction or coronary artery bypass grafting or percutaneous coronary intervention or documented stenosis of an epicardial coronary artery \[\>50% left main or \>70% left anterior descending, circumflex or right coronary artery\]) 2. Persistent or permanent atrial fibrillation (not paroxysmal atrial fibrillation) 3. Previous ischemic or embolic stroke 4. Peripheral arterial disease (previous surgical or percutaneous revascularisation or a documented stenosis greater than 50% of a major peripheral arterial vessel). 5. Chronic kidney disease (defined as an estimated glomerular filtration rate \<60mL/min/1.73m2 or eGFR 60-90mL/min/1.73m2 and UACR \>300mg/g). 6. Regular loop diuretic use (any dose at any dosing interval) for \>30 days. 7. COPD (evidenced by one of the following; PFTs showing airway obstruction, diagnosis by respiratory physician, CT scan reporting presence of emphysema or treatment with national guideline-advocated COPD therapy). Exclusion Criteria: * Inability to give informed consent e.g., due to significant cognitive impairment. * Previous documented diagnosis of heart failure. * Echocardiogram or NT-proBNP interpreted as excluding heart failure within 12 months. * Currently receiving scheduled renal replacement therapy. * Anyone who, in the investigators' opinion, is not suitable to participate in the trial for other reasons e.g., a diagnosis which may compromise survival over the study period