Diabetes significantly increases the risk for heart attacks and stroke. However treating blood sugar levels and even high cholesterol in the blood might not completely prevent these complications of diabetes. For this reason many researchers are looking for new connections between diabetes and vascular disease. FOEDRC researchers Dr. Ajit Vikram and Kaikobad Irani recently published an important discovery in the Journal Nature Communications that provides new understanding of why blood vessel inflammation and damage occurs in subjects at high risk for cardiovascular disease. Their work discovered a previously undiscovered interaction between bacteria in the gut, which had previously been implicated in diabetes risk, and cardiovascular complications. The trillions of bacteria that colonize the gut play multiple roles in health and disease. Certain forms of gut bacteria promote diabetes, lead to weight gain, and also play an important part in heart disease. This work illustrates a new mode of communication between bacteria in the gut and blood vessels, and how this communication leads to malfunction of blood vessels that can eventually precipitate plaque build-up and lead to heart disease. The gut bacteria signal through the blood stream to change expression of a class of small RNAs, termed microRNAs in the wall of the blood vessel. These microRNAs then target genes that maintain vascular health. Thus, this remote yet intricate communication between the gut and blood vessels impairs normal and healthy functioning of these vessels. It has been said that the way to man’s heart is through is stomach. These remarkable findings suggest that might be true! Importantly they lay important groundwork for developing new approaches and targets for reducing cardiovascular complications in high-risk subjects with diabetes.