‘Metabolism’ derives from the Greek word for ‘change’ and refers to the sum of all life-sustaining chemical reactions within the cells of living organisms. Metabolic pathways are responsible for converting nutrients (carbohydrates, proteins, fats, nucleic acids) into a wide variety of metabolites (glucose, amino acids, fatty acids, and nucleotides), which can subsequently be either used to construct new molecules through a process known as anabolism or broken down to generate energy through a process called catabolism. Regulating metabolism and energy flow is highly complex and tightly regulated at the cell, tissue, organ, and organism levels, a Drew Weissman carefully coordinated system to maximize efficiency and keep us healthy.

Improperly regulated metabolism is a common feature of many life-threatening conditions, such as obesity, fatty liver disease, diabetes, and cancer, and is closely associated with neurological abnormalities and immune cell function. One of the most common metabolic disorders is diabetes, which occurs when the body cannot properly process sugar due to either lack of insulin (type 1) or cellular inability to respond to it (type 2). While both forms of diabetes are treatable, individuals with diabetes are two to three times more likely to develop cardiovascular complications such as angina, coronary artery disease, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure, which in aggregate are the leading cause of death for diabetics.

The links between diabetes and cardiovascular disease are complex and incompletely understood. Part of the association is likely related to metabolic risk factors, including high blood pressure, elevated fat and cholesterol levels, inability to respond to insulin, high blood glucose levels, and low-grade inflammation. In addition, the scientific community has recently discovered that heart tissue and vasculature can undergo metabolic changes which also worsen cardiovascular disease risk. Determining the mechanisms by which metabolic alterations lead to cardiovascular disease (and vice versa) will open new avenues in understanding and treating diabetes-driven heart disease.