Why Women with Diabetes Face a Greater Risk for Heart Disease

By Dr. David Samadi

When it comes to heart health, diabetes is a serious red flag—especially for women. While the condition raises the risk of heart disease for everyone, women with diabetes often face significantly worse outcomes than men.

The Risk Is Real—and Higher for Women

The numbers don’t lie: Women with diabetes are twice as likely to develop heart disease compared to women without diabetes. They also tend to suffer heart attacks earlier in life—and those heart attacks are more likely to be fatal.

Even more concerning? Women are more likely to die after their first heart attack than men. That’s a sobering reality that raises an important question: Why the gender gap?

Possible Reasons Behind the Disparity

There’s no single answer, but several contributing factors may help explain the difference:

1. Differences in Treatment

Studies suggest women with diabetes often don’t receive the same level of care as men. They’re less likely to be prescribed cholesterol-lowering medications, like statins, or other drugs that protect the heart. For instance, within the first year of a diabetes diagnosis, women were found to be 10% less likely than men to use cholesterol-lowering medications—and 7% less likely to take other heart-protective therapies.

2. Underrepresentation in Research

Historically, women have been underrepresented in clinical trials, especially those focused on heart disease. This limits what we know about how cardiovascular disease develops and progresses in women—particularly those with diabetes.

3. Biological Differences

Sex hormones and body composition also come into play. Women generally have a higher percentage of body fat than men at the time of diabetes diagnosis, and obesity is a known contributor to heart disease. In addition, women with diabetes often show higher levels of systemic inflammation, which can damage blood vessels and raise cardiovascular risk.

Women are also more likely to have multiple risk factors at the time of diagnosis, such as high cholesterol, high blood pressure, and abdominal obesity—all of which further strain heart health.

4. Challenges with Risk Factor Control

A 2023 study in the journal AHA Circulation found that women had lower rates of control over key cardiovascular risk factors—like blood sugar, blood pressure, cholesterol, and smoking—when compared to men.

A Call for Better Care—and Self-Advocacy

We’re just not as good at treating women who have diabetes and are at risk for heart disease.  Whether that’s due to provider bias, patient behavior, or lack of access to care is still up for debate. But the trend is consistent—and concerning.

Clearly, more research is needed that focuses specifically on women. With women making up more than half the population, the lack of gender-specific data is both a challenge and an opportunity.

What Women Can Do to Protect Their Heart

Until we close the research gap, women must take a proactive approach to their health. Here’s how:

• Get Regular Checkups: Work closely with a healthcare provider to monitor heart health and manage diabetes effectively.
• Know Your Numbers: Track five key indicators—total cholesterol, LDL (“bad”) cholesterol, blood pressure, blood sugar, and body mass index (BMI).
• Be Active: The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity (like brisk walking) or 75 minutes of vigorous aerobic activity weekly, plus muscle-strengthening exercises twice a week.
• Speak Up: If something doesn’t feel right, advocate for yourself. Ask questions. Don’t be afraid to push for the care and screenings you deserve.

The Bottom Line

Once diagnosed with diabetes, women need to be especially vigilant. The risk for heart disease is real—but with the right steps, it can be managed. By staying informed, taking preventive action, and working closely with a healthcare team, women can protect their hearts and live healthier, longer lives.

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.