PEOPLE with type 2 diabetes have a heightened risk of cardiovascular complications due to impaired fibrous repair in atherosclerotic plaques, according to a study by Lund University Diabetes Centre researchers.
This research aimed to investigate the mechanisms underlying the increased cardiovascular risk in type 2 diabetes. Atherosclerosis, characterised by the accumulation of fats, cells, and connective tissue in arteries, is a major cause of strokes and heart attacks. The study analysed atherosclerotic plaques from 219 individuals, 72 of whom had type 2 diabetes. The findings revealed that plaques from patients with type 2 diabetes had lower levels of protective connective tissue, likely due to reduced production of the growth factor TGF-beta2. High blood sugar levels were linked to this impairment, as hyperglycemia disrupts the formation of stabilising proteins, further increasing cardiovascular risk.
These results highlight the importance of strict glycemic control to reduce cardiovascular complications in individuals with type 2 diabetes, and the need for treatment strategies beyond traditional risk factor management. While current therapies address blood lipids, blood pressure, and lifestyle changes, they do not target the molecular mechanisms specific to type 2 diabetes. Researchers now aim to explore tailored treatments that could stabilise plaques or enhance the production of protective proteins. This approach holds potential for reducing the incidence of strokes and heart attacks in patients with type 2 diabetes, offering new hope in clinical practice.
Katrina Thornber, EMJ
Reference
Singh P et al. Dysregulation of MMP2-dependent TGF-ß2 activation impairs fibrous cap formation in type 2 diabetes-associated atherosclerosis. Nat Commun. 2024;15:10464.
