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How diabetes can actually reshape your heart
We know type 2 diabetes can lead to poor heart health. What we don’t know is why.
It’s true that people with diabetes often have high blood pressure and high cholesterol. Those are both risk factors for heart problems, so it makes sense that the potential for heart failure and stroke is also higher.
But what about diabetics who don’t have those risk factors? Why are they also at risk of these heart issues?
Researchers at the University of Sydney decided to get to the bottom of this, and what they discovered was pretty scary. Turns out diabetes can actually reshape the heart muscle…
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The physical heart changes wrought by diabetes
To better understand the effect of diabetes on the heart, the researchers studied heart tissue from both transplant recipients and healthy individuals. By examining human heart tissue directly, the researchers could see how diabetes influences heart biology in real human patients rather than relying solely on animal models.
The results indicated diabetes is more than just a risk factor for heart disease. It actively accelerates heart failure by interfering with essential biological processes and reshaping heart muscle at the microscopic level.
“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,” says study co-lead Dr. Benjamin Hunter of the University of Sydney.
“Our findings show that diabetes alters how the heart produces energy, maintains its structure under stress, and contracts to pump blood,” Hunter says. “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.”
How the mechanics work
When the heart is healthy, it generates energy mainly from fats, with glucose and ketones also contributing. Previous research has illustrated that glucose use increases during heart failure. However, diabetes impairs this process by reducing insulin sensitivity of glucose transporters in heart muscle cells.
“We observed that diabetes worsens the molecular characteristics of heart failure in patients with advanced heart disease and increases the stress on mitochondria — the powerhouse of the cell which produces energy,” Hunter says.
Beyond energy production, the researchers discovered that diabetes affects the proteins responsible for heart muscle contraction and calcium regulation. In patients with both diabetes and ischemic heart disease, the most common cause of heart failure, there were lower levels of these proteins being produced. At the same time, excess fibrous tissue accumulated within the heart, making the muscle more rigid and less able to pump blood efficiently.
In short, diabetes disrupts how heart cells produce energy, weakens the heart muscle’s structure, and triggers fibrous tissue buildup that makes the heart have to work harder. These changes are particularly severe in people with ischemic heart disease.
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What this means for the future
According to study co-lead Sean Lal of the University of Sydney, by identifying mitochondrial dysfunction and fibrosis-related pathways, the researchers can now 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,” Lal says.
What does this mean for you? If you already have type 2 diabetes, it’s essential to do everything you can to manage your condition. That may include medication and lifestyle changes (such as diet and exercise). It may even be possible to reverse your condition by losing weight.
If you have metabolic syndrome, often the precursor to diabetes, you can reduce your risks through diet and exercise. The American Heart Association recommends eating plenty of whole grains, fruits, vegetables, skinless poultry, fish, nuts, low-fat or fat-free dairy products, lean meats and vegetable protein. It also says to limit processed foods, saturated and trans fats, red meat, sodium and added sugars.
To really lower your risk of diabetes, make sure your eating plan includes plenty of legumes. One study shows a few servings of legumes a week can slash your diabetes risk by a whopping 35%. Some of the healthiest and most powerful legumes include:
- Chickpeas
- Black beans
- Lentils
- Kidney beans
- Adzuki beans
- Fava beans
- Soybeans
- Peas
- Lima beans
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Sources:
Left ventricular myocardial molecular profile of human diabetic ischaemic cardiomyopathy — EMBO Molecular Medicine
Type 2 diabetes physically changes the human heart, study finds — ScienceDaily
Prevention and Treatment of Metabolic Syndrome — American Heart Association
By Carolyn Gretton
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