A new study by researchers at the University of Leicester has revealed that women with type 2 diabetes face nearly double the risk of undetected heart damage compared to men, despite having no outward signs of heart disease.

The study, one of the most detailed of its kind, focused on coronary microvascular dysfunction (CMD)—a form of early and silent heart damage caused by reduced blood flow in the heart’s tiniest vessels. Using cutting-edge MRI scans and data from four separate studies conducted at the NIHR Leicester Biomedical Research Centre (BRC), scientists discovered that 46% of women with type 2 diabetes showed signs of CMD, compared to just 26% of men.

Women More Vulnerable to Silent Heart Damage

“These are early signs of heart disease that go completely unnoticed during routine health checks—and it’s women who appear to be at greater risk,” said Professor Gerry McCann, NIHR Research Professor and the study’s lead investigator. “None of the participants had symptoms such as chest pain or breathlessness, yet imaging revealed otherwise.”

Sex-Specific Risk Factors Identified

Dr. Gaurav Gulsin, co-author and NIHR Clinical Lecturer, highlighted that the causes behind CMD varied between men and women. Among women, higher body weight (BMI) was the most significant risk factor, while in men, elevated blood pressure had a stronger link to CMD.

“This means our approach to assessing heart health and treating cardiovascular risk may need to be tailored differently for men and women,” Dr. Gulsin noted.

Breakthrough in Collaborative Research

The study stands out not just for its findings, but also for how it was conducted—through collaboration between the Cardiovascular, Lifestyle, and Diabetes research teams at NIHR Leicester BRC.

“This is a perfect example of how cross-specialty teamwork can lead to deeper insights into complex diseases,” said Professor Melanie Davies CBE, Director of the NIHR Leicester BRC and co-author of the study.

Implications for Prevention

The research suggests that early intervention strategies, such as weight management for women and blood pressure control for men, could play a vital role in preventing heart damage before it evolves into heart failure—a common outcome in people with type 2 diabetes.

“These findings could reshape the way we approach heart disease prevention in diabetic patients,” Professor Davies added, “helping to detect problems earlier and improve long-term outcomes.”

The study emphasizes the need for more personalized, gender-aware approaches in cardiovascular care—especially for individuals living with type 2 diabetes.