Diabetes drugs affect hearts of men and women differently

Research may explain conflicting data surrounding some medications

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Robert Boston

Janet B. McGill, MD, and Robert J. Gropler, MD, look through the PET scanner they and their colleagues used to study the heart’s response to common diabetes therapies. They found large differences in heart metabolism between men and women taking widely used diabetes drugs.

Widely used treatments for type 2 diabetes have different effects on the hearts of men and women, even as the drugs control blood sugar equally well in both sexes, according to School of Medicine researchers.

In particular, the commonly prescribed diabetes drug metformin had positive effects on heart function in women but not in men, who experienced a shift in metabolism thought to increase the risk of heart failure.

“We saw dramatic sex differences in how the heart responds to the different therapies,” said senior author Robert J. Gropler, MD, professor of radiology. The study appeared in the American Journal of Physiology — Heart and Circulatory Physiology.

To the researchers’ knowledge, this is the first study to investigate sex differences in the heart’s response to diabetes treatments. In type 2 diabetes, the pancreas continues to make insulin, but the body can’t use it effectively to move glucose out of the blood and into the tissues. And for reasons that are not entirely clear, patients with diabetes are at higher risk for heart failure.

"We saw dramatic sex differences in how the heart responds to the different therapies."
— Robert J. Gropler, MD

“It is imperative that we gain understanding of diabetes medications and their impact on the heart to design optimal treatment regimens for patients,” said Janet B. McGill, MD, professor of medicine and a study co-author.

The investigators evaluated commonly prescribed diabetes drugs in 78 patients. The research suggests that divergent responses in men and women may provide at least a partial explanation for the conflicting data surrounding some diabetes drugs. Specifically, the proportion of men and women participating in a clinical trial may play an unappreciated role in whether drugs are deemed safe and effective.

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