MME and type 2 diabetes mellitus: Other pathogenetic mechanisms that underlies HF occurrence in T2DM patients are a stimulation of renal sympathetic nerves that interferes with adiponectin signaling, in turn cause over-activity of neprilysin, and thereby induce maladaptive impact of natriuretic peptides on tissues exacerbated by a detrimental effect of abdominal obesity and HF.