NT- proBNP: Linking Cardiovascular and Microvascular Diabetes Complications

Background: NT-proBNP is an established biomarker of myocardial stress and heart failure. Recent evidence suggests its association with cardiovascular and microvascular complications in diabetes. Objective: To provide an updated narrative review integrating recent guidelines of the American Diabetes Association (ADA), contemporary literature, and our institutional clinical data. Methods: Narrative review of ADA Standards of Care (2026), major international cohort studies, and our institution's previously published data. Results: Elevated NT-proBNP is associated with increased cardiovascular risk and higher prevalence of diabetic retinopathy, neuropathy, and progressive nephropathy. Conclusion: NT-proBNP may serve as an integrative biomarker for comprehensive cardiovascular and microvascular risk stratification in diabetes.