Background: Abnormalities of glucose (G) and insulin (I) metabolism may play a role in the etiology and progression of HF. This study examined the prevalence and clinical correlation of G and I abnormalities in a stable HF cohort.Methods: Fasting G and I levels were obtained on 664 HF patients age (sd) 64 (10), EF 28% (7), NYHA-FC: I/II-64%, III/IV-36%.Results: 177 patients (27%) were known to have diabetes mellitus (DM). Of the remaining 487 patients, 111 (23%) had elevated G (=<6.1 mM), with 53 (11%) in the DM range (G =<7.0 mM). In patients without known DM; the mean G, I (sd) levels and fasting insulin resistance index (FIRI = G x I/25) were 5.8 (2) mM, 13.3 (19) mU/L and 3.7 (8) (normal (sd), I = 4 (7) mU/L, FIRI = 1.4 (1)). G and I levels were higher in patients with NYHA =<III than NYHA =<II. In addition, a greater proportion of patients with NYHA =<III had DM than NYHA =<II. (Table)Conclusion: G and I abnormalities are common in HF patients and appear to worsen as HF symptoms increase. This suggests that abnormalities of G or I are either a consequence or a predictor of worsening symptoms of HF. Further study is needed to explore the role of G and I abnormalities in HF.