Nat Commun. 2026 Apr 18. doi: 10.1038/s41467-026-71809-x. Online ahead of print.
ABSTRACT
Heart disease is the leading cause of morbidity and mortality in individuals with diabetes, due largely to risks associated with ischaemic injuries such as myocardial infarction (MI). We use human population genetic data to demonstrate that classical cardiovascular disease risk biomarkers, including common measures of hyperglycaemia, do not fully account for the increased risk of post-MI mortality in patients with diabetes. This study therefore systematically evaluates glycaemic stress underpinning cardiovascular risk in diabetes. Here, we show using in vivo studies in adult male mice and in vitro models that glycaemic variability, rather than sustained hyperglycaemia alone, is a key risk factor for cardiomyocyte dysfunction and increased susceptibility to myocardial injury in diabetes. We further demonstrate that patient plasma assays can elucidate the predictive potential of glycaemic variability as a primary contributor to cardiomyocyte dysfunction and subclinical cardiac injury in diabetes. These findings provide preclinical models for mechanistic and drug discovery studies and inform strategies for managing cardiovascular outcomes in patients with diabetes.
PMID:42000722 | DOI:10.1038/s41467-026-71809-x