Researchers from The University of Sydney have revealed that type 2 diabetes directly alters the heart’s structure and energy systems, offering insights into why people with diabetes are at greater risk of heart failure. They found that diabetes causes distinct molecular changes to heart cells and structural changes to the muscle — especially in patients with ischaemic cardiomyopathy, the most common cause of heart failure. This means that diabetes is not just a co-morbidity for heart disease — it actively worsens heart failure by disrupting key biological processes and reshapes the heart muscle at a microscopic level. “Under healthy conditions, the heart primarily uses fats but also glucose and ketones as fuel for energy,” Hunter continued. “Now that we’ve linked diabetes and heart disease at the molecular level and observed how it changes energy production in the heart while also changing its structure, we can begin to explore new treatment avenues,” he said.