According to the International Diabetes Foundation, one in 11 adults worldwide has been diagnosed with diabetes. All these people are at increased risk of heart and cardiovascular disease because high blood sugar damages blood vessels and harms nerves that control the heart.

Not only that, they also tend to develop heart disease earlier than others. Fifteen years sooner, in fact, compared with people who don’t have diabetes.

Women with diabetes have it even tougher. A report published by the European Society of Cardiology details the greater toll that diabetes takes on women’s heart health than on men’s.

Peripheral artery disease, called PAD, is a key example. PAD occurs when the vessels carrying blood to body parts other than the brain or heart become clogged with fatty plaques, slowing the blood flow through the arteries. The legs and feet usually suffer the worst, sometimes requiring amputation. Among people with diabetes, women are almost twice as likely as men to have PAD.

Another condition, heart failure, affects women with diabetes five times more often than women without diabetes. Male diabetes sufferers are only twice as likely as other men to come down with heart failure. Coronary artery disease is yet another cardiovascular illness where women with diabetes fare worse than men.

The report’s authors say they aren’t sure why women’s hearts seem so much more vulnerable than men’s to these diabetes complications. Perhaps future research will give us an answer.

This Valentine’s Day, do your heart a favor and vow to keep your blood sugar in check, especially if you’re a woman.