Diabetes Drugs Affect Hearts of Men and Women Differently

A recent study conducted at Washington University School of Medicine is claiming that widely used type 2 diabetes treatments have different effects on the hearts of men and women. To the researcher’s knowledge, this is the first study of its kind. The study can be found in the American Journal of Physiology – Heart and Circulatory Physiology December issue.


“We saw dramatic sex differences in how the heart responds to the different therapies,” professor of radiology and senior author Robert J. Gropler, MD, said. “Our study suggests that we need to better define which therapies are optimal for women with diabetes and which ones are optimal for men.”


Seventy-eight patients were divided into three groups, who were given three separate medications. The first group metformin alone, a drug that acts to reduce glucose production by the liver and helps the body react to insulin. The second group was given metformin plus rosiglitazone, a drug also used to improve sensitivity to insulin as well as move free fatty acids out of the blood. The third group received metformin and Lovaza, a kind of fish oil. Participants were sent through positron emission tomography (PET) scans to take images of the heart and measure blood flow, fatty acid and glucose uptake by the heart, and oxygen consumption among other measures to monitor metabolism throughout the body and its influence on the heart.

“The most dramatic difference between men and women is with metformin alone,” said Gropler. “Our data show it to have a favorable effect on cardiac metabolism in women and an unfavorable one in men.”


Interestingly enough, when the groups were not separated by sex, no differences in heart metabolism were noted. But when separated by sex, the effects were startlingly different though blood sugar levels remained controlled in all patients. Particularly, metformin had a detrimental effect on the hearts of men, causing the metabolism of the heart to burn more fats and less sugar.


“Instead of making heart metabolism more normal in men, metformin alone made it worse, looking even more like a diabetic heart,” said Gropler. “But in women, metformin had the desired effect – lowering fat metabolism and increasing glucose uptake by the heart.”


Gropler says that excessive burning of fat by the heart leads to negative changes in heart muscle, which could lead to heart failure. It is a known fact that diabetics are more prone to heart failure. The researchers of this study believe that their findings could serve as a link between conflicting data of certain diabetic drugs. For instance, in 2010 the Food and Drug Administration (FDA) banned rosiglitazone because of cardiovascular safety concerns. Last month the ban was lifted due to recent review of new data.


“We now know there are sex differences at baseline, both in the metabolism of healthy hearts and in the hearts of patients with diabetes,” Gropler said. “We are adding the message that these sex differences persist in how patients respond to drugs. For patients with diabetes, we are going to have to be more attentive to sex differences when we design therapies.”


Though this news may come as a shock to some, it is imperative to maintain your health with the assurance of having all of the essential diabetic accessories to manage your illness; whether that be insulin pen needles or pump supplies, have a diabetic supply company at hand for all your needs and continue to follow your doctor’s prescribed regimen.

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