Researchers at the University of Sydney have found new evidence that type 2 diabetes directly changes the structure of the heart and the way it receives energy. This helps explain why people with diabetes have a significantly higher risk of heart failure.
In a study published in the journal EMBO Molecular Medicine, scientists compared heart tissue from transplant patients with tissue from healthy donors and found that diabetes causes specific molecular malfunctions and structural changes in the heart muscle. These changes were especially pronounced in ischemic cardiomyopathy, one of the main causes of heart failure.
Direct examination of human heart tissue allowed scientists to see the real effects of diabetes, rather than relying solely on data from animal experiments.
The results showed that diabetes is not just a comorbid disease: it actively accelerates the development of heart failure by interfering with key biological processes and changing heart tissue at a microscopic level.
Normally, the heart primarily gets its energy from fat, with glucose and ketones being an additional source. In heart failure, glucose consumption usually increases, but diabetes disrupts this mechanism by reducing the sensitivity of heart cells to insulin. In addition, it turned out that diabetes reduces the production of proteins that are responsible for contracting the heart muscle and controlling calcium levels. In these patients, more fibrous tissue accumulates, causing the heart to become stiffer and less able to pump blood.