New research from the University of Sydney offers key insights into how diabetes increases heart failure risk.
A groundbreaking study from the University of Sydney reveals that type 2 diabetes directly changes the structure and energy systems of the heart, providing critical insights into why individuals with diabetes face a higher risk of heart failure.
Published in EMBO Molecular Medicine, the research was led by Dr Benjamin Hunter and Associate Professor Sean Lal from the School of Medical Sciences.
The research team analyzed heart tissue donated from patients undergoing heart transplants in Sydney. Their analysis uncovered distinct molecular and structural changes in the heart muscle cells of people with both type 2 diabetes and ischaemic cardiomyopathy—the most common form of heart failure.
Using advanced confocal microscopy, they observed a build-up of fibrous tissue in the heart, along with changes in how the heart produces energy and contracts. These changes were particularly evident in individuals with both heart disease and diabetes, showing how diabetes worsens heart failure.
Under normal conditions, the heart uses fats, glucose, and ketones for energy. In heart failure, glucose uptake typically increases.
However, diabetes interferes with this adaptation by reducing the insulin sensitivity of glucose transporters in heart muscle cells. This leads to added stress on the mitochondria—the cell’s powerhouse—which compromises energy production.
Additionally, researchers observed a decrease in the production of structural proteins critical for muscle contraction and calcium regulation. These changes, combined with increased fibrous tissue, further limit the heart’s ability to pump effectively.
RNA sequencing revealed that these protein-level changes were mirrored at the gene expression level, especially in pathways related to energy metabolism and tissue structure. These insights could help shape future diagnostic criteria and treatment approaches in both cardiology and endocrinology.
The discovery of mitochondrial dysfunction and fibrosis-related pathways opens the door to novel therapies aimed at managing heart failure in people with diabetes. Dr Lal emphasized the significance of these findings in guiding new treatments and informing clinical practices to better care for patients with co-existing heart disease and diabetes.
If you care about heart health, please read studies that Changing blood pressure readings is a hidden sign of heart disease and common type 2 diabetes drugs may raise heart risk.
For more about heart health, please read studies about root cause of heart rhythm disorders and Warning signal from the kidneys can predict future heart failure risk.
The study is published in EMBO Molecular Medicine.
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