Report highlights hidden heart conditions in women living with type 2 diabetes

Study reports women with type 2 diabetes could be twice as likely to have heart damage than men.

Women with type 2 diabetes could have double the risk of experiencing hidden heart damage compared to men.

The findings come from a study by researchers at the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) and funded by a National Institute for Health and Care Research (NIHR) Research Professorship.

The results were recently published in the Journal of Cardiovascular Magnetic Resonance, investigating coronary microvascular dysfunction (CMD) to reveal sex-specific risk patterns in people with no signs of heart disease.

CMD is a form of early, silent heart damage caused by impaired blood flow in the heart’s smallest vessels.

Using MRI scans and data taken from four studies conducted at the NIHR Leicester Biomedical Research Centre (BRC), researchers found that 46% of the women with type 2 diabetes had signs of CMD, compared to just 26% of the men.

Gerry McCann, NIHR Research Professor at the University of Leicester and lead investigator of the study, said: “We’re seeing early warning signs of heart disease that aren’t picked up through routine checks, and its women who seem to be most affected.

“What makes this study remarkable is that all participants were asymptomatic, which means they had no diagnosed heart problems, no chest pain, and no shortness of breath. Yet the scans told a different story.”

Dr Gaurav Gulsin, co-author and NIHR Clinical Lecturer added: “The study also found that the drivers of CMD differ by sex. In women, CMD was most strongly linked to higher body weight (BMI). However, in men, higher blood pressure was the more significant factor.

“This suggests we may need to rethink how we assess cardiovascular risk, and that women and men could warrant sex-specific treatments.”

Melanie Davies CBE, Professor of Diabetes Medicine, Director of the NIHR Leicester BRC and study co-author, said: “This is a fantastic example of what happens when teams across specialisms come together with a shared goal to spot disease earlier and improve outcomes for patients, this is exactly what the BRC was set up to do.

“The findings have significant implications for future prevention strategies. Interventions like weight loss for women and blood pressure control for men could help reduce early heart damage long before it progresses into heart failure which is a condition especially common in people with type 2 diabetes.”

Researchers hope to test these targeted interventions in future clinical trials.

Read the report in the Journal of Cardiovascular Magnetic Resonance