The longer you live with type 2 diabetes, the greater your risk of heart problems. This isn't just a headline; it's a critical wake-up call, highlighting the insidious link between the duration of diabetes and the health of your heart. But how does this happen? And what can we do about it? Let's dive in.
Researchers from the Karolinska Institutet have uncovered a troubling connection: the longer someone has type 2 diabetes (T2D), the higher their chances of developing cardiovascular disease. They've pinpointed changes in red blood cells and a specific molecule as potential early warning signs. This research offers a glimmer of hope, suggesting possible avenues for early intervention and prevention.
Why is diabetes such a cardiovascular risk factor?
The American Heart Association classifies diabetes as a major, manageable risk factor for cardiovascular disease. Individuals with T2D face a significantly increased risk of heart attacks, strokes, and heart failure compared to those without diabetes. Even when blood sugar levels are controlled through treatment, the risk of heart disease and stroke remains elevated, especially in T2D patients. This is often due to additional factors that raise cardiovascular risk, such as high blood pressure, abnormal cholesterol and triglycerides, obesity, lack of physical activity, and smoking.
This increased risk is largely due to endothelial dysfunction, the lining of your blood vessels not working as well as it should. The longer the disease persists, the worse this dysfunction becomes. However, the exact mechanisms at play haven't been fully understood – until now.
How does diabetes duration affect the inner workings of our blood vessels?
Previous research by the same team showed that red blood cells from people with T2D can harm the inner lining of blood vessels. This happens because of reduced microRNA (miRNA)-210-3p, a tiny regulator of gene expression, especially under low-oxygen conditions. This miRNA plays a key role in metabolism, oxidative stress, and blood vessel function.
To further investigate, researchers examined both mice with T2D of varying ages and patients with T2D, some newly diagnosed and others with the condition for a year or more, up to seven years. They found that red blood cells from older diabetic mice and individuals with long-standing T2D impaired endothelial function. This vascular dysfunction was linked to lower levels of miR-210-3p, increased oxidative stress, and higher glycerol-3-phosphate dehydrogenase 2 expression. The good news? Restoring miR-210-3p reversed these effects.
"What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease. It is only after several years that red blood cells develop a harmful effect on blood vessels," explains Zhichao Zhou, associate professor at the Department of Medicine, Solna, Karolinska Institutet, and lead author of the study.
So, what does this mean for you?
These findings highlight that the duration of diabetes is a crucial factor in red blood cell-mediated vascular damage. They also point to miR-210-3p as a potential biomarker for diabetes-related cardiovascular disease. Researchers are now working to determine if this can be used in larger studies to identify those at greatest risk.
"If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications," says Eftychia Kontidou, a doctoral student and the first author of the study.
But here's where it gets controversial... Could this research lead to a new way to assess and manage the cardiovascular risk in people with diabetes? Could we see earlier interventions based on the duration of the disease and the levels of miR-210-3p? What do you think about the potential of using biomarkers to predict and prevent cardiovascular disease in people with diabetes? Share your thoughts in the comments below!**
References
- Eftychia Kontidou,Aida Collado,Rawan Humoud,Kesavan Manickam,John Tengbom,Tong Jiao,Michael Alvarsson,Jiangning Yang,Linda Mellbin,Ali Mahdi,John Pernow,Zhichao Zhou; Long Duration of Type 2 Diabetes Drives Erythrocyte-Induced Vascular Endothelial Dysfunction: A Link to miRNA-210-3p.Diabetes2026; db250463.https://doi.org/10.2337/db25-0463
- A new study explains the link between long-term diabetes and vascular damage. News release. EurekAlert. January 9, 2026. Accessed January 9, 2025. https://www.eurekalert.org/news-releases/1111963
- Cardiovascular Disease and Diabetes. American Heart Association. Updated April 2, 2024. Accessed January 9, 2026. https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks/cardiovascular-disease--diabetes
