Researchers at Johns Hopkins investigated why the risk of heart disease in type 2 diabetes differs between men and women. In a large study, they found that sex hormones may play an important role in this difference. In men, higher testosterone levels were associated with a lower risk of heart disease. Conversely, increasing levels of estradiol were associated with a higher risk of heart disease in men. These hormonal effects were not observed in the women in the study. The results suggest that sex hormones may have a differential effect on cardiovascular risk depending on gender. These findings could lead to more personalized approaches to preventing heart disease in patients with type 2 diabetes.