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Recent scientific data indicates that people who live for many years with type 2 diabetes face an increased risk of cardiovascular disease. A study from the Karolinska Institute, published in the journal Diabetes, offers a new biological explanation for this gradual increase in risk, linked to changes within red blood cells themselves. The study also identifies a molecule that may serve as an early warning sign of potential future heart problems.

It is medically established that type 2 diabetes increases the likelihood of heart attacks and strokes, and that this risk worsens with the duration of the disease. Previous studies have shown that red blood cells play a role in influencing blood vessel function in people with diabetes. According to a report published by the European news network Euronews in Brussels on Sunday, the study's novelty lies in the direct link between the duration of the illness and the timing and severity of these changes. It revealed that red blood cells, after many years of disease, can transition from merely reflecting an existing health condition to actually damaging the walls of blood vessels. The research team employed a two-pronged approach, examining animal models alongside analyzing samples from individuals with type 2 diabetes. The results showed that red blood cells taken from mice and long-term diabetic patients disrupted the normal function of blood vessels. In contrast, red blood cells from newly diagnosed patients did not exhibit the same effect. However, a follow-up after seven years revealed that these same patients began to show similar harmful changes in their blood cells. When the researchers restored the levels of the microRNA-210 molecule within the red blood cells to normal, a clear improvement in blood vessel function was observed. In this context, Chichao Zhou, associate professor at the Karolinska Institute and lead author of the study, explains that the essence of the findings does not lie in... The presence of diabetes itself, and even its duration, indicates that red blood cells only begin to have direct negative effects on blood vessels after several years.

Early Warning
These findings open the door to considering the microRNA-210 molecule within red blood cells as a potential biomarker for identifying patients most at risk of cardiovascular complications.

The research team is currently working to verify the reliability of this marker in larger population studies, aiming to move from biological understanding to clinical application.

"Being able to identify at-risk patients before actual blood vessel damage occurs could be a game-changer in prevention," says Efteja Contido, PhD student and first author of the study, "before actual blood vessel damage occurs could be a game-changer in prevention, as it allows for early intervention and reduces the risk of complications."

A research team including experts from the International Institute for Applied Systems Analysis (IIASA) and the Vienna University of Economics and Business (WU Vienna) calculated the global economic cost of diabetes to countries.

This disease was chosen because it is a chronic and one of the most widespread diseases in the world, affecting one in ten adults, which poses an increasing challenge to healthcare systems. And the economies of countries.

The study, conducted across 204 countries over a specific period, revealed that providing healthcare for diabetes patients costs the world approximately $10 trillion annually, equivalent to 0.2% of annual GDP.

When informal care is included, the costs reach $152 trillion, or 1.7% of global GDP.

In this context, Klaus Breitner, an economist at the University of Vienna and one of the study's authors, says, "Care providers often partially leave the labor market, which creates additional economic costs."

The researcher attributes the high proportion of informal care, which represents between 85% and 90% of the total economic burden, to the fact that the number of people with diabetes exceeds the number of deaths from it by a ratio of 30 to 50 times.

Although diabetes is more prevalent in low-income countries, the United States bears the highest costs related to its treatment, followed by China and India.

In the same vein, co-author Michael Kuhn, acting head of the Economic Frontiers Research Group at IIASA, points out that "the Czech Republic records the highest burden in terms of GDP." The overall cost per capita is 0.5%, followed by the United States and Germany at 0.4%. Ireland, Monaco, and Bermuda bear the highest costs per capita, at $18,000, $12,000, and $8,000, respectively. The study explains that one of the key differences between high- and low-income countries lies in the distribution of the burden between treatment costs and workforce losses. Treatment costs represent 41% of the economic burden (excluding informal care) in high-income countries, compared to only 14% in low-income countries. Cohen comments, "This clearly shows that medical treatment systems for chronic diseases like diabetes are only accessible to high-income countries." Diabetes During the Coronavirus Pandemic

The study also showed that diabetes was a major factor in increasing mortality rates from COVID-19. During the crisis, the economic burden rose from 0.16% to 0.22% of GDP in China, from 0.4% to 0.65% in the United States, and from 0.4% to 0.45% in Germany. Breitner explained, "Previous estimates of diabetes costs were often based on overly simplistic assumptions and tended to ignore economic dynamics. But this research takes into account labor market effects, such as absenteeism due to caregiving responsibilities. It also recognizes that healthcare spending does not necessarily reduce economic output, but often represents a shift from consumer spending to healthcare spending."

Prevention Methods

Compared to other diseases such as Alzheimer's, dementia, and cancer, the study indicates that the economic impact of diabetes is enormous, but it emphasizes that "the most effective way to prevent diabetes and reduce its economic impact is to promote healthy lifestyles." Regular physical activity combined with a balanced diet can significantly reduce the risk of developing the disease.

Early detection also plays a crucial role, through comprehensive screening programs for the entire population, and rapid diagnosis and early treatment of individuals who exhibit symptoms or risk factors.

Kohn concludes, "Such measures are particularly important for low-income countries, where high rates of underdiagnosis and increased mortality from infectious diseases make diabetes a severe risk factor for the stability of healthcare systems."