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Diabetes increases the risk of heart failure, more so in women than men

Diabetes increases the risk of heart failure, more so in women than men

A global study of 12 million people has found diabetes increases the risk of heart failure and this increase is greater for women than men.

Researchers from The George Institute for Global Health determined that this differential was greater in type 1 than type 2 diabetes. Type 1 diabetes is associated with a 47% excess risk of heart failure in women compared to men, whilst type 2 diabetes has a 9% higher excess risk of heart failure for women than men.

The findings published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) highlight the need for further sex-specific research into diabetes and how the condition can potentially contribute to heart complications.

According to the International Diabetes Federation (IDF), 415 million adults worldwide live with diabetes – with approximately 199 million of them being women.1 The IDF expects by the year 2040 around 313 million women will be suffering from the disease. Diabetes is the ninth leading cause of death in women and claims 2.1 million female lives every year, more so than men. The number one leading cause of death for women is heart disease.

“It is already known that diabetes puts you at greater risk of developing heart failure but what our study shows for the first time is that women are at far greater risk – for both type 1 and type 2 diabetes,” said lead author and research fellow Dr Toshiaki Ohkuma from The George Institute.

“The increased risk of heart failure following a diabetes diagnosis is significantly greater in women than men which highlights the importance of intensive prevention and treatment of diabetes in women. Further research is required to understand the mechanisms underpinning the excess risk of heart failure conferred by diabetes [particularly type 1] in women and to reduce the burden associated with diabetes in both sexes.”

Key findings:

  • Women with type 1 diabetes were associated with a more than five-fold increased risk of heart failure compared with those without diabetes. For men, the risk was 3.5-fold higher.
  • Corresponding increases in risks for heart failure associated with type 2 diabetes were 95% in women and 74% in men.
  • Researchers also found that both type 1 and type 2 diabetes were stronger risk factors for heart failure in women than men.
  • Type 1 diabetes was associated with a 47% greater excess risk of heart failure in women compared with men.
  • Type 2 diabetes was associated with a 9% greater excess risk of heart failure in women than men.

According to Diabetes Australia, the prevalence of diabetes is now so widespread that it has become the major health crisis of the 21st century. It is the largest challenge facing the Australian health system with around 1.7 million sufferers nationwide. More than 119,000 Australians are living with type 1 diabetes, an autoimmune condition, whereas 1.3 million Australians are living with type 2 diabetes, the effects of which can be exacerbated by lifestyle factors such as poor diet and lack of exercise. It’s estimated that the number of people suffering from diabetes globally will increase to 642 million by 2040.

Study co-author Dr Sanne Peters, of The George Institute for Global Health at the University of Oxford, said there are a number of reasons why women with diabetes are at greater risk of heart complications.

“Women were reported to have two years’ longer duration of prediabetes than men and this increased duration may be associated with greater excess risk of heart failure in women,” said Dr Peters. “Some major concerns are that women are also being undertreated for diabetes, are not taking the same levels of medications as men and are less likely to receive intensive care.”

The IDF reports that girls and women with diabetes experience a range of challenges. Gender roles, power imbalances, socioeconomic inequalities resulting in poor diet and lack of physical activity can all influence vulnerability to diabetes.2 Women’s limited access to health services and lack of pro-activity when it comes to seeking treatment for health problems can also amplify the impact of diabetes, particularly in developing countries.

Diabetes is one of the leading causes of cardiovascular disease, blindness, kidney failure and lower-limb amputation. In pregnancy, poorly controlled diabetes increases the risk of maternal and foetal complications. Women with type 2 diabetes also have a significantly increased risk of depression in comparison to men.

The George Institute has been leading gender specific research and has already shown women with diabetes have a significantly greater excess risk of stroke and coronary heart disease as well as the non-cardiovascular complications of dementia and cancer than men. It is currently investigating gender differences in stroke as well as other chronic diseases.

1 and 2 https://diabetesvoice.org/en/diabetes-views/diabetes-is-a-serious-womens-health-issue/

Materials provided by the University of New South Wales

Researchers develop new sensor to help detect early-stage cancer

Researchers develop new sensor to help detect early-stage cancer

A new device that can detect very low concentrations of cancer markers in blood tests could one day help doctors diagnose cancer at its earliest stages, researchers say.

A group of chemists from UNSW Sydney’s Australian Centre for NanoMedicine (ACN) and biologists from UNSW’s Lowy Cancer Research Centre have created an early version of the first “nanopore blockade sensor” that can analyse disease biomarkers at a rapid, single molecule level.

Cancer biomarkers – or tumour markers – are substances, often proteins, that are produced by the body in response to cancer growth.

UNSW Scientia Professor Justin Gooding, who developed the technology with a team of scientists, said a key approach to reducing deaths from life-threatening cancers was to diagnose cancers as early as possible, when treatments were far more effective.

“Developing ultrasensitive cancer marker sensors is critical because it allows for very early detection after the cancer has occurred but before any symptoms start appearing,” said Professor Gooding, from the School of Chemistry at UNSW Science. “The best way to cure cancer is to detect and diagnose it early. What this sensor can do is detect biomarkers and single molecules at much lower levels than current blood tests can, and we can get results in several minutes.”

The nanopore blockade sensors work by using magnetic particles to capture biomarkers and bring them to one of many small pores drilled through a silicon membrane. If a magnetic nanoparticle has captured the biomarker, it will block the pore. By counting which pores are blocked the biomarkers can be counted, one molecule at a time. Importantly, the device can be used on whole blood samples regularly taken at pathology labs.

‘This sensor can detect biomarkers and single molecules at much lower levels than current blood tests can, and we can get results in several minutes.’

The technology is about five to 10 years away from being available to patients and needs to go through rigorous further research and trials now, said Professor Gooding. “This is a really hot area in cancer research, especially as it could potentially have a substantial impact as an effective means to estimate how effective treatment will be and assess how likely it is for cancer to reoccur.”

The research and development of the sensor is funded by the Australian Research Council through the ARC Centre of Excellence in Convergent Bio-Nano Science and Technology and an ARC Australian Laureate Fellowship.

Materials provided by the University of New South Wales

micro submarines

‘Submarines’ small enough to deliver medicine inside human body

Cancers in the human body may one day be treated by tiny, self-propelled ‘micro-submarines’ delivering medicine to affected organs after UNSW Sydney chemical and biomedical engineers proved it was possible.

In a paper published in Materials Today, the engineers explain how they developed micrometre-sized submarines that exploit biological environments to tune their buoyancy, enabling them to carry drugs to specific locations in the body.

Corresponding author Dr Kang Liang, with both the School of Biomedical Engineering and School of Chemical Engineering at UNSW, says the knowledge can be used to design next generation ‘micro-motors’ or nano-drug delivery vehicles, by applying novel driving forces to reach specific targets in the body.

“We already know that micro-motors use different external driving forces – such as light, heat or magnetic field – to actively navigate to a specific location,” Dr Liang says.

“In this research, we designed micro-motors that no longer rely on external manipulation to navigate to a specific location. Instead, they take advantage of variations in biological environments to automatically navigate themselves.”

What makes these micro-sized particles unique is that they respond to changes in biological pH environments to self-adjust their buoyancy. In the same way that submarines use oxygen or water to flood ballast points to make them more or less buoyant, gas bubbles released or retained by the micro-motors due to the pH conditions in human cells contribute to these nanoparticles moving up or down.

This is significant not just for medical applications, but for micro-motors generally.

“Most micro-motors travel in a 2-dimensional fashion,” Dr Liang says.

“But in this work, we designed a vertical direction mechanism. We combined these two concepts to come up with a design of autonomous micro-motors that move in a 3D fashion. This will enable their ultimate use as smart drug delivery vehicles in the future.”

Dr Liang illustrates a possible scenario where drugs are taken orally to treat a cancer in the stomach or intestines. To give an idea of scale, he says each capsule of medicine could contain millions of micro-submarines, and within each micro-submarine would be millions of drug molecules.

“Imagine you swallow a capsule to target a cancer in the gastrointestinal tract,” he says.

“Once in the gastrointestinal fluid, the micro-submarines carrying the medicine could be released. Within the fluid, they could travel to the upper or bottom region depending on the orientation of the patient.

“The drug-loaded particles can then be internalised by the cells at the site of the cancer. Once inside the cells, they will be degraded causing the release of the drugs to fight the cancer in a very targeted and efficient way.”

For the micro-submarines to find their target, a patient would need to be oriented in such a way that the cancer or ailment being treated is either up or down – in other words, a patient would be either upright or lying down.

Dr Liang says the so-called micro-submarines are essentially composite metal-organic frameworks (MOF)-based micro-motor systems containing a bioactive enzyme (catalase, CAT) as the engine for gas bubble generation. He stresses that he and his colleagues’ research is at the proof-of-concept stage, with years of testing needing to be completed before this could become a reality.

Dr Liang says the research team – comprised of engineers from UNSW, University of Queensland, Stanford University and University of Cambridge – will be also looking outside of medical applications for these new multi-directional nano-motors.

“We are planning to apply this new finding to other types of nanoparticles to prove the versatility of this technique,” he says.

Materials provided by University of New South Wales