Advances in the application of nanoparticles for the diagnosis and treatment of diabetic cardiomyopathy.

As a frequent and serious cardiovascular complication of diabetes mellitus, diabetic cardiomyopathy (DCM) typically presents with an asymptomatic onset during its initial phase, followed by gradual worsening over time. Currently, no universally accepted and effective DCM-specific targeted therapeutic strategy is available. Recently, nanotechnology has gained recognition as a viable strategy to address the shortcomings of traditional treatments, leveraging its size-dependent effects, large specific surface area, and ability to integrate multiple functions. This article presents a structured summary of recent developments regarding nanoparticle utilization for diagnostic and therapeutic purposes in DCM. First, from a functional perspective, we analyze the core advantages of nanoparticles in improving pharmacokinetic profiles, enhancing drug stability and bioavailability, facilitating targeted myocardial delivery, enabling pathological microenvironment-responsive release, and constructing theranostic platforms. Second, according to material type, we discuss the current research status and the operational mechanisms of different nanocarrier systems-including polymeric nanoparticles, liposomes, inorganic nanoparticles, and extracellular vesicles-in antifibrotic therapy, antioxidation intervention, regulation of energy metabolism, and early diagnostic assessment. Finally, based on current limitations and successful experience from other cardiovascular diseases we outline future directions, including biomimetic design, upgraded targeting strategies, diversified administration routes, safety evaluation, and combined applications with hydrogels or myocardial patches. Although nanotechnology has shown promising potential in animal models of DCM, clinical translation still requires continued breakthroughs in material innovation, quality control, and long-term safety validation.