Type 2 diabetes is one of the fastest-growing health problems in the world. The condition affects how the body controls blood sugar and can lead to serious complications, including heart disease, stroke, kidney failure, nerve damage, and vision problems.
While many people think diabetes is caused mainly by eating too much sugar, the reality is much more complex. Body weight, physical activity, sleep, smoking, blood pressure, cholesterol levels, and overall lifestyle all play important roles.
Now, a large new study suggests that taking care of heart health may also be one of the best ways to prevent type 2 diabetes, especially among older women.
The research was led by scientists at New York University and published in the journal Diabetology. The investigators analyzed information from the Women’s Health Initiative, one of the largest and longest-running studies of women’s health ever conducted in the United States.
The researchers examined health data from 19,403 postmenopausal women whose information was collected between 1993 and 2024. These women were followed for an average of 16 years, giving scientists a rare opportunity to observe how lifestyle and health habits influence disease risk over a long period of time.
To measure cardiovascular health, the researchers used a system called Life’s Essential 8, developed by the American Heart Association. This framework includes eight factors known to support heart health.
These are eating a healthy diet, staying physically active, avoiding tobacco, getting enough sleep, maintaining a healthy body weight, controlling cholesterol, managing blood sugar, and keeping blood pressure in a healthy range.
Each participant received a score between 0 and 100. Higher scores indicated better overall cardiovascular health. The researchers then examined whether women with higher scores were less likely to develop type 2 diabetes.
The results were striking. During the study period, about 20 percent of women developed type 2 diabetes. However, women who achieved the highest Life’s Essential 8 scores had a 57 percent lower risk of developing diabetes compared with women who had the lowest scores.
The researchers also looked at which individual factors seemed most important. Blood sugar levels and body mass index, commonly known as BMI, showed the strongest relationship with diabetes risk. This finding was not surprising because excess body weight is already known to be one of the strongest risk factors for type 2 diabetes.
To strengthen their findings, the team performed a second analysis using a larger group of 99,269 women. This analysis focused on five lifestyle factors that were available for more participants: diet, exercise, smoking, sleep duration, and body weight.
Even with this simplified approach, the benefits remained clear. Women with the healthiest lifestyle scores had a 40 percent lower risk of developing diabetes than those with the lowest scores.
Age also appeared to matter. Women younger than 60 years old experienced the greatest reduction in diabetes risk when they maintained higher cardiovascular health scores. The study also found particularly strong benefits among Hispanic women.
Another interesting finding involved waist size. Women with a waist circumference of 31.5 inches or less had the lowest risk of diabetes when combined with high cardiovascular health scores. This result supports previous research showing that fat stored around the abdomen may be especially important in diabetes development.
The findings highlight how closely heart health and diabetes prevention are connected. Although cardiovascular disease and diabetes are often discussed as separate conditions, they share many of the same risk factors. Poor diet, physical inactivity, excess weight, smoking, and inadequate sleep can contribute to both diseases.
The study also offers an encouraging message. It suggests that meaningful improvements in health do not require a single miracle solution. Instead, a combination of healthy habits can work together to substantially reduce the risk of chronic disease.
When reviewing the study, several strengths stand out. The research included a large number of participants and followed them for many years.
This long follow-up period allowed researchers to observe real-world health outcomes rather than short-term changes. The consistency of the findings across both the Life’s Essential 8 and the simplified five-factor analysis further strengthens confidence in the results.
However, there are also limitations. Some lifestyle information was self-reported, meaning participants may not always have remembered or reported their habits accurately. In addition, the study was observational, which means it can identify associations but cannot prove that the healthy habits directly caused the lower diabetes risk.
Even with these limitations, the findings provide strong evidence that improving cardiovascular health may be one of the most effective ways to reduce the risk of type 2 diabetes.
The results reinforce the idea that it is never too late to adopt healthier habits. By eating well, staying active, maintaining a healthy weight, sleeping adequately, avoiding tobacco, and managing important health markers, many women may significantly improve both their heart health and their chances of avoiding diabetes later in life.
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Source: New York University.
