Type 2 diabetes alters how the heart “maintains its structure under stress”, latest research has indicated.
New insights from the University of Sydney have found that type 2 diabetes also directly alters how the heart produces energy and contracts to pump blood.
As part of the investigation, the team of researchers examined the heart tissue of people undergoing heart transplantation and of healthy donors.
They discovered that type 2 diabetes causes distinct molecular changes to heart cells and structural changes to the muscle.
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First author Dr Benjamin Hunter said: “We’ve long seen a correlation between heart disease and type 2 diabetes, but this is the first research to jointly look at diabetes and ischemic heart disease and uncover a unique molecular profile in people with both conditions.
“Our findings show that diabetes alters how the heart produces energy, maintains its structure under stress, and contracts to pump blood.”
He added: “Using advanced microscopy techniques, we were able to see direct changes to the heart muscle as a result of this, in the form of a build-up of fibrous tissue.”
According to data, more than 1.2 million people in Australia are living with type 2 diabetes and heart disease is the leading cause of death in the country.
Corresponding author Professor Sean Lal said: “Our research links heart disease and diabetes in ways that have never been demonstrated in humans, offering new insights into potential treatment strategies that could one day benefit millions of people in Australia and globally.”
By disrupting key biological processes and reshaping the heart muscle at a microscopic level, type 2 diabetes actively worsens heart failure, the study has reported.
Dr Hunter noted: “The metabolic effect of diabetes in the heart is not fully understood in humans.
“Under healthy conditions, the heart primarily uses fats but also glucose and ketones as fuel for energy.”
He added: “It has previously been described that glucose uptake is increased in heart failure, however, type 2 diabetes reduces the insulin sensitivity of glucose transporters – proteins that move glucose in and out of cells – in heart muscle cells.
“We observed that type 2 diabetes worsens the molecular characteristics of heart failure in people with advanced heart disease and increases the stress on mitochondria – the powerhouse of the cell which produces energy.”
Professor Lal concluded: “Now that we’ve linked type 2 diabetes and heart disease at the molecular level and observed how it changes energy production in the heart while also changing its structure, we can begin to explore new treatment avenues.
“Our findings could also be used to inform diagnosis criteria and disease management strategies across cardiology and endocrinology, improving care for millions of patients.”
Read the study in the journal EMBO Molecular Medicine.
