Type 2 diabetes poses a silent, escalating threat to cardiovascular health, with new research revealing how the disease gradually impairs blood vessel function over years, not just from diagnosis. A study from Karolinska Institutet identifies red blood cell changes as a key factor in this long-term damage, intensifying the risk of heart attacks and strokes.
Globally, millions live with type 2 diabetes, a condition known to elevate the risk of heart disease, but the precise mechanisms and timeline of this vascular decline have remained complex. This recent investigation sheds critical light on the insidious progression, underscoring that the duration of living with diabetes significantly amplifies its danger to the heart.
Published in the journal Diabetes, the findings challenge the notion that vascular damage is uniform from the outset, instead pointing to a delayed but profound shift in cellular behavior. This understanding is vital for developing more targeted strategies to prevent severe cardiovascular complications.
Red blood cells: The hidden culprits in vascular damage
For years, researchers have understood that red blood cells can influence blood vessel health in diabetic individuals. However, the study from Karolinska Institutet, as reported by ScienceDaily on January 22, 2026, distinctly shows that the duration of type 2 diabetes is a critical factor.
The research team examined both animal models and human patients, observing a clear distinction: red blood cells from newly diagnosed individuals showed no detrimental effect on blood vessel function. In stark contrast, those from patients with long-standing diabetes directly disrupted normal vascular processes.
Zhichao Zhou, associate professor at the Department of Medicine, Solna, Karolinska Institutet, and lead author, emphasized this point. “What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease,” Zhou stated.
He added that “It is only after several years that red blood cells develop a harmful effect on blood vessels.” This key insight highlights a progressive deterioration, where initially healthy red blood cells gradually acquire damaging properties over time, as seen in patients followed for seven years.
microRNA-210: A potential early warning system
The study also pinpointed a specific molecule, microRNA-210, found within red blood cells, as a crucial player in this vascular dysfunction. When scientists restored normal levels of microRNA-210 in damaged red blood cells, they observed an improvement in blood vessel function, suggesting its direct involvement.
This discovery opens a promising avenue for early detection and intervention. Identifying elevated levels of microRNA-210 could serve as a biomarker, signaling an increased risk of cardiovascular complications before irreversible damage occurs. This represents a significant step towards personalized medicine in diabetes management.
Eftychia Kontidou, a doctoral student from the same research group and the study’s first author, articulated this potential. “If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications,” she noted.
Researchers are now investigating whether this biomarker approach can be scaled up and applied effectively in larger population studies, offering a proactive tool to safeguard the hearts of individuals living with type 2 diabetes.
The Karolinska Institutet study provides compelling evidence that the silent progression of type 2 diabetes damages blood vessels not just through its presence, but through its duration. Recognizing the time-dependent changes in red blood cells and the role of microRNA-210 offers a critical new perspective on managing this chronic condition.
Future research will undoubtedly focus on validating microRNA-210 as a reliable clinical biomarker and developing interventions that target these specific red blood cell alterations. This could fundamentally change how cardiovascular risk is assessed and mitigated, moving towards a more predictive and preventative model for those navigating life with type 2 diabetes.
